MEDICARE: SANDERS COUNSELING SERVICES, LLC

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

General Provider Information

NPI Number	:	1659967289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDERS COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	2202 US HWY 41N UNIT E #175
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2202 US HWY 41N UNIT E #175
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420
Country	:	US
Telephone Number	:	270-883-1502
Fax Number	:

Authorized Official
Title or Position	:	OWNER/COUNSELOR
Name	:	SARA SANDERS
Credential	:
Telephone Number	:	270-883-1502

Provider Enumeration Date	:	12/17/2020
Last Update Date	:	01/10/2021

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