Provider Demographics
NPI:1427863711
Name:SANDERS, STEVEN ASHLEY (CDCA190470)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ASHLEY
Last Name:SANDERS
Suffix:
Gender:M
Credentials:CDCA190470
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 E TOWN ST STE 1450
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-6601
Mailing Address - Country:US
Mailing Address - Phone:888-805-1330
Mailing Address - Fax:
Practice Address - Street 1:4000 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3593
Practice Address - Country:US
Practice Address - Phone:614-334-6903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
OHCDCA190470101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)