Healthcare Provider Details

I. General information

NPI: 1245100155
Provider Name (Legal Business Name): SANDERS & CO PSS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 LILY GREEN CT NW
CONCORD NC
28027-2300
US

IV. Provider business mailing address

1115 LILY GREEN CT NW
CONCORD NC
28027-2300
US

V. Phone/Fax

Practice location:
  • Phone: 336-902-2324
  • Fax:
Mailing address:
  • Phone: 336-902-2324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARKEE DIONTA SANDERS
Title or Position: MR.
Credential:
Phone: 336-902-2324