Individual
IVAN THOMAS SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
115 N HARVIN ST, SUMTER, SC 29150-4956
(803) 778-2835
(803) 778-4017
Mailing address
441 N MAIN ST, SUMTER, SC 29150-4232
(803) 775-5080
(803) 773-6256
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
10417
SC
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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