Provider Demographics
NPI:1194130740
Name:LOSEE-WOODS, SANDRA (LMHC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LOSEE-WOODS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 IRMA AVE
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-2831
Mailing Address - Country:US
Mailing Address - Phone:516-220-7041
Mailing Address - Fax:
Practice Address - Street 1:898 OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:EAST NORWICH
Practice Address - State:NY
Practice Address - Zip Code:11732-1051
Practice Address - Country:US
Practice Address - Phone:516-220-7041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005932101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health