Healthcare Provider Details

I. General information

NPI: 1336709336
Provider Name (Legal Business Name): CHRISTOPHER HEATH SANDERS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SPRING ST STE 205
SHREVEPORT LA
71101-3757
US

IV. Provider business mailing address

501 PENNSYLVANIA AVE
MINDEN LA
71055-3428
US

V. Phone/Fax

Practice location:
  • Phone: 318-670-3170
  • Fax:
Mailing address:
  • Phone: 903-746-9565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8109
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: