Healthcare Provider Details

I. General information

NPI: 1699428896
Provider Name (Legal Business Name): EDWIN V SANCHEZ ASSOCIATE LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 MADRID PL
DULLES VA
20189-8502
US

IV. Provider business mailing address

2420 MARTIN RD STE 200
FAIRFIELD CA
94534-8610
US

V. Phone/Fax

Practice location:
  • Phone: 520-301-6889
  • Fax:
Mailing address:
  • Phone: 707-399-4520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-22656
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: