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General NPI Number Information
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NPI Number | 1871770701
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Entity Type | Individual
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Provider Name | SANDRA ANNE LANDERS LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 2500 BOBCAT VILLAGE CENTER RD UNIT F
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City | NORTH PORT
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State | FL
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Zip | 34288-8476
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Country | US
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Telephone | 954-676-8860
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Fax | 888-821-8320
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Provider Business Mailing Address
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Address Line | PO BOX 494081
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City | PORT CHARLOTTE
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State | FL
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Zip | 33949-4080
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Country | US
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Telephone | 954-668-7689
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Fax | 888-821-8320
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW 5153
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License Number State | FL
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