Provider Demographics
NPI:1972736064
Name:SADE, ELEANOR BANDIN (MSCP, LISAC)
Entity type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:BANDIN
Last Name:SADE
Suffix:
Gender:F
Credentials:MSCP, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 KAWAINUI ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2408
Mailing Address - Country:US
Mailing Address - Phone:623-451-4850
Mailing Address - Fax:623-451-4850
Practice Address - Street 1:549 KAWAINUI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734
Practice Address - Country:US
Practice Address - Phone:623-451-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11803101YA0400X
HI103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ450399Medicaid