Sandra June Channell, CDCA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Jackson, OH
NPI 1801312723 · NPPES record last updated Aug 22, 2017
Key facts
- NPI
- 1801312723
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 163618 (OH)
- Practice address
- 345 E Main St
Jackson, OH 45640-1779 - Phone
- (740) 288-3767
- Fax
- (740) 288-1111
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 163618 | OH | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Outreach Services, LTD | Past | Accepting new patients | |
| Spectrum Outreach Services, LTD | Addiction (Substance Use Disorder) | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 163618 | OH | Yes |
Addresses
Primary practice location
345 E Main St
Jackson, OH 45640-1779
Mailing address
214 S 4TH St
Ironton, OH 45638-1610
Phone (740) 532-3767
Other providers in Jackson, OH
- Corey S Carver
- Sarah Caseman
- Mariah Ashton Casey
- Micaela Casto
- Courtney E Causey
- Tracie Louise Channell
- Abigail Elizabeth Christensen
- Mark G. Christopher
- Jerimy Clonch
- Tracie Renee Clutter
All providers in Jackson, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.