Provider Demographics
NPI:1982752416
Name:SANDERS, STEPHEN O (M DIV ADMINSTRATOR)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:O
Last Name:SANDERS
Suffix:
Gender:M
Credentials:M DIV ADMINSTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E MAIN ST
Mailing Address - Street 2:STE 300
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4541
Mailing Address - Country:US
Mailing Address - Phone:803-328-9600
Mailing Address - Fax:803-329-7141
Practice Address - Street 1:225 E MAIN ST
Practice Address - Street 2:STE 300
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4541
Practice Address - Country:US
Practice Address - Phone:803-328-9600
Practice Address - Fax:803-329-7141
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral