Provider Demographics
NPI:1881983906
Name:SHACHAR-KRASNOFF, SANDRA ARIELA (PHD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ARIELA
Last Name:SHACHAR-KRASNOFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:SHACHAR
Other - Last Name:HENDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:4567 WEST PINE BLVD.
Mailing Address - Street 2:601
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2188
Mailing Address - Country:US
Mailing Address - Phone:314-440-5433
Mailing Address - Fax:
Practice Address - Street 1:1034 S BRENTWOOD BLVD STE 555
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1265
Practice Address - Country:US
Practice Address - Phone:314-440-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019197103TC1900X
MO2011006689103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling