Provider Demographics
NPI:1881304541
Name:SANDIDGE, YALAUNDA (LCSW)
Entity type:Individual
Prefix:
First Name:YALAUNDA
Middle Name:
Last Name:SANDIDGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:YALAUNDA
Other - Middle Name:
Other - Last Name:SANDIDGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 9541
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-0026
Mailing Address - Country:US
Mailing Address - Phone:479-435-4207
Mailing Address - Fax:479-935-3180
Practice Address - Street 1:3623 JOHNSON MILL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6412
Practice Address - Country:US
Practice Address - Phone:479-435-4207
Practice Address - Fax:479-935-3180
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR12107-C1041C0700X
AR12107-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical