MEDICARE: KAREN L SANDERS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	11245	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3278LC	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1104933928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN L SANDERS LPC

Provider Business Mailing Address
First Line	:	4171 N MESA ST STE A106
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-1422
Country	:	US
Telephone Number	:	915-532-2030
Fax Number	:	915-585-2129

Provider Business Practice Location Address
First Line	:	4171 N MESA ST STE A106
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-1422
Country	:	US
Telephone Number	:	915-532-2030
Fax Number	:	915-585-2129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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Directions to “ KAREN L SANDERS LPC” Practice Location

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