Healthcare Provider Details

I. General information

NPI: 1467813006
Provider Name (Legal Business Name): NIKESHA S SANDERS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIKESHA CAMP

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 05/31/2025
Certification Date: 05/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MAIN ST
ELLENDALE DE
19941-2066
US

IV. Provider business mailing address

2701 N 16TH ST STE 316
PHOENIX AZ
85006-1266
US

V. Phone/Fax

Practice location:
  • Phone: 302-424-5660
  • Fax: 302-424-5661
Mailing address:
  • Phone: 602-650-1212
  • Fax: 602-636-5283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: