Provider Demographics
NPI:1215983986
Name:EMBRY, SANDRA LYNN (EDD, LPC, NCC)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LYNN
Last Name:EMBRY
Suffix:
Gender:F
Credentials:EDD, LPC, NCC
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:LYNN
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD, LPC, NCC
Mailing Address - Street 1:1909 PLEASANT DRIVE
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661
Mailing Address - Country:US
Mailing Address - Phone:256-320-7222
Mailing Address - Fax:256-320-7222
Practice Address - Street 1:1909 PLEASANT DRIVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661
Practice Address - Country:US
Practice Address - Phone:256-320-7222
Practice Address - Fax:256-320-7222
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1240101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
51519496OtherBCBS FEP