Provider Demographics
NPI:1538710934
Name:SANDER, LYNDSEY ANN (TLPC)
Entity type:Individual
Prefix:MRS
First Name:LYNDSEY
Middle Name:ANN
Last Name:SANDER
Suffix:
Gender:F
Credentials:TLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10142 W WESTPORT CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-6716
Mailing Address - Country:US
Mailing Address - Phone:316-250-5848
Mailing Address - Fax:
Practice Address - Street 1:6700 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-6334
Practice Address - Country:US
Practice Address - Phone:316-945-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional