Provider Demographics
NPI:1316109432
Name:LEVEY LUNDEN, SANDRA E (M ED, , RC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:LEVEY LUNDEN
Suffix:
Gender:F
Credentials:M ED, , RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 BROOKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-5054
Mailing Address - Country:US
Mailing Address - Phone:360-527-2796
Mailing Address - Fax:
Practice Address - Street 1:1609 BROOKVIEW PL
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-5054
Practice Address - Country:US
Practice Address - Phone:360-527-2796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC 00050466101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC 00050466OtherWA STATE CREDENTIAL NUMBER