Provider Demographics
NPI:1053958827
Name:SANDERS, FAITH (LMHC)
Entity type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1066 SW DARTMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-8516
Mailing Address - Country:US
Mailing Address - Phone:716-803-2520
Mailing Address - Fax:
Practice Address - Street 1:1066 SW DARTMOUTH AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-8516
Practice Address - Country:US
Practice Address - Phone:407-476-8014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17516101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health