Healthcare Provider Details

I. General information

NPI: 1568753465
Provider Name (Legal Business Name): HEATHER SANDS MS, M.ED., MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2011
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 HANCOCK CT NE STE D
ALBUQUERQUE NM
87109-4592
US

IV. Provider business mailing address

3301 COORS BLVD NW STE R
ALBUQUERQUE NM
87120-1268
US

V. Phone/Fax

Practice location:
  • Phone: 505-414-1769
  • Fax:
Mailing address:
  • Phone: 505-414-1769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: