Cristal Lynn Lake-Sanders, NCC, LPC, M.ED.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701004299 Issued in VA

Practice address

4906 Millridge Pkwy E
Midlothian, VA 23112-4828

Phone

(804) 399-0676

Fax

(804) 744-5202

NPI assigned

Feb 17, 2009

Last updated

Feb 19, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1396984274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14308 LONG HILL RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124302",
            "telephone_number": "804-399-0676",
            "fax_number": "804-744-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4906 MILLRIDGE PKWY E",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124828",
            "telephone_number": "804-399-0676",
            "fax_number": "804-744-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE-SANDERS",
        "first_name": "CRISTAL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NCC, LPC, M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992959928",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.