Provider Demographics
NPI:1164656484
Name:GARVER, SANDRA L (LPC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:GARVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4544
Mailing Address - Country:US
Mailing Address - Phone:503-686-3989
Mailing Address - Fax:503-686-3989
Practice Address - Street 1:223 SW 8TH STREET SANDRA GARVER LPC
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4544
Practice Address - Country:US
Practice Address - Phone:503-686-3989
Practice Address - Fax:503-686-3989
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1641101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR5006364450Medicaid