Provider Demographics
NPI:1588060982
Name:FIELDS, SANDI (LCSW)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SANDI
Other - Middle Name:
Other - Last Name:BYRD-FIELDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:27 CLYDE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5039
Mailing Address - Country:US
Mailing Address - Phone:848-863-9495
Mailing Address - Fax:848-220-1940
Practice Address - Street 1:27 CLYDE RD STE 102
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5039
Practice Address - Country:US
Practice Address - Phone:848-863-9495
Practice Address - Fax:848-220-1940
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06010800104100000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker