Provider Demographics
NPI:1154576452
Name:SANDERS, RITA L (LPC)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:L
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:305 N VINE ST UNIT 201
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1652
Mailing Address - Country:US
Mailing Address - Phone:815-258-9733
Mailing Address - Fax:815-320-3825
Practice Address - Street 1:305 N VINE ST UNIT 201
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1652
Practice Address - Country:US
Practice Address - Phone:815-258-9733
Practice Address - Fax:815-320-3825
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007398101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health