Provider Demographics
NPI:1982363644
Name:VOSS, SANDRA J (LSW, LMSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:J
Last Name:VOSS
Suffix:
Gender:F
Credentials:LSW, LMSW
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:J
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LPHA, MSW
Mailing Address - Street 1:2701 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5351
Mailing Address - Country:US
Mailing Address - Phone:309-779-2031
Mailing Address - Fax:
Practice Address - Street 1:2701 17TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5351
Practice Address - Country:US
Practice Address - Phone:309-779-2031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150104825104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker