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General NPI Number Information
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NPI Number | 1497007413
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Entity Type | Organization
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Legal Business Name | SANDERLIN COUNSELING SERVICES
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 1821 ROYAL AVE SUITE 3
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City | MONROE
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State | LA
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Zip | 71201-5721
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Country | US
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Telephone | 318-323-7575
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Fax | 318-239-4716
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Provider Business Mailing Address
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Address Line | 3900 JEFFERSON DAVIS DR
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City | MONROE
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State | LA
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Zip | 71201-1940
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Country | US
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Telephone | 318-323-7575
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Fax | 318-239-4716
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA SANDERLIN
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Credential | LPC-S
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Telephone | 318-323-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3965
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License Number State | LA
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