Provider Demographics
NPI:1891587390
Name:SANDERS, JADELYN NICOLE (MSED)
Entity type:Individual
Prefix:
First Name:JADELYN
Middle Name:NICOLE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6328 GOLDSBERRY RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:IN
Mailing Address - Zip Code:47920-9745
Mailing Address - Country:US
Mailing Address - Phone:765-586-1089
Mailing Address - Fax:
Practice Address - Street 1:11 N 3RD ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47901-1206
Practice Address - Country:US
Practice Address - Phone:765-201-0528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health