Provider Demographics
NPI:1366244931
Name:CHMIELEWSKI, SANDRA L (LMHC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:CHMIELEWSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20517 GRAND VISTA LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3456
Mailing Address - Country:US
Mailing Address - Phone:952-412-4985
Mailing Address - Fax:
Practice Address - Street 1:2406 CYPRESS GLEN DR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4609
Practice Address - Country:US
Practice Address - Phone:813-710-4307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH25382101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional