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NPI Code Detail

MEDICARE: LOIS J SANDLAND LCSW

MEDICARE:   LOIS J SANDLAND  LCSW
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
1101YM0800XMental Health Counselor
2101YM0800XMental Health CounselorCSW.00002075CO
3101YM0800XMental Health CounselorSW16118

General Provider Information

NPI Number : 1619257516
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOIS J SANDLAND LCSW
Provider Business Mailing Address
First Line : 484 N IDLEDALE DR
Second Line :
City : PUEBLO WEST
State : CO
Zip : 81007-1145
Country : US
Telephone Number : 719-232-0975
Fax Number :
Provider Business Practice Location Address
First Line : 2020 N ACADEMY BLVD STE 280
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-1568
Country : US
Telephone Number : 719-232-0975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2011
Last Update Date : 10/29/2020

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Directions to “ LOIS J SANDLAND LCSW” Practice Location

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