Provider Demographics
NPI:1366592107
Name:SAWYER, SANDRA C (MSW LICSW)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:C
Last Name:SAWYER
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:EAST DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02641
Mailing Address - Country:US
Mailing Address - Phone:508-385-7474
Mailing Address - Fax:508-385-1848
Practice Address - Street 1:1070 RT 134
Practice Address - Street 2:
Practice Address - City:EAST DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02641
Practice Address - Country:US
Practice Address - Phone:508-385-7474
Practice Address - Fax:508-385-1848
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106091104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
03554OtherCIGNA HEALTH CARE
007242OtherHARVARD PILGRIM
007181OtherCHAMPUS TRICARE
753091OtherTUFTS HEALTH
MAP04197OtherBCBS
199616000OtherCMSP
199616000OtherMAGELLAN HMO BLUE
199616000OtherMAGELLAN HMO BLUE