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General NPI Number Information
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NPI Number | 1023494648
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Entity Type | Individual
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Provider Name | GLENDA K. SANDERS LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 840 E 87TH ST 100
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City | CHICAGO
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State | IL
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Zip | 60619-6248
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Country | US
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Telephone | 708-738-2318
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Fax |
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Provider Business Mailing Address
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Address Line | 9229 S SANGAMON ST
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City | CHICAGO
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State | IL
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Zip | 60620-2732
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Country | US
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Telephone | 708-738-2318
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180.009525
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.009525
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.009525
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License Number State | IL
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