Provider Demographics
NPI:1104469113
Name:SANDERS, ANTOINETTE C (LISW-CP)
Entity type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:C
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:MISS
Other - First Name:ANTOINETTE
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5158
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-5158
Mailing Address - Country:US
Mailing Address - Phone:864-582-2411
Mailing Address - Fax:864-487-8734
Practice Address - Street 1:1341 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4733
Practice Address - Country:US
Practice Address - Phone:864-514-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC154191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical