Basic Information
| Provider Information | |||||||||
| NPI: | 1740918978 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANDRIDGE THERAPY & CONSULTING, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4404 BURKE DR | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700032812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042591898 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4034 CANAL ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701196021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042591898 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2022 | ||||||||
| LastUpdateDate: | 08/15/2022 | ||||||||
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| AuthorizedOfficialLastName: | SANDRIDGE | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
| AuthorizedOfficialMiddleName: | LEONA | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5042591898 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD, LCSW | ||||||||
| NPICertificationDate: | 08/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.