1366592107 NPI number — MS. SANDRA C SAWYER MSW LICSW

Table of content: MS. SANDRA C SAWYER MSW LICSW (NPI 1366592107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366592107 NPI number — MS. SANDRA C SAWYER MSW LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAWYER
Provider First Name:
SANDRA
Provider Middle Name:
C
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366592107
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 356
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST DENNIS
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-385-7474
Provider Business Mailing Address Fax Number:
508-385-1848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1070 RT 134
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST DENNIS
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-385-7474
Provider Business Practice Location Address Fax Number:
508-385-1848
Provider Enumeration Date:
01/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  106091 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03554 . This is a "CIGNA HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007242 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007181 . This is a "CHAMPUS TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 753091 . This is a "TUFTS HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: P04197 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 199616000 . This is a "CMSP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 199616000 . This is a "MAGELLAN HMO BLUE" identifier . This identifiers is of the category "OTHER".




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