Provider Demographics
NPI:1982253845
Name:SANDS, ANDALYN DAMIDA (LPC-I)
Entity Type:Individual
Prefix:
First Name:ANDALYN
Middle Name:DAMIDA
Last Name:SANDS
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 VERHALEN AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-2466
Mailing Address - Country:US
Mailing Address - Phone:713-560-4375
Mailing Address - Fax:
Practice Address - Street 1:4002 VERHALEN AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-2466
Practice Address - Country:US
Practice Address - Phone:713-560-4375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79422101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty