Individual
ELISSA LYNN SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004797
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11878515
CAQH PROVIDER ID
—
05
—
170428375B
—
GA
01
—
424748
MHN PROVIDER ID
—
Enumeration date
10/21/2008
Last updated
04/27/2026
Update your record
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