Healthcare Provider Details

I. General information

NPI: 1518862515
Provider Name (Legal Business Name): LISA MAY SANDQUIST MA, T-LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 NW SCHOOL ST
ANKENY IA
50023-1746
US

IV. Provider business mailing address

227 NW SCHOOL ST
ANKENY IA
50023-1746
US

V. Phone/Fax

Practice location:
  • Phone: 515-964-5003
  • Fax:
Mailing address:
  • Phone: 515-964-5003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number141257
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: