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NPI Code Detail

MEDICARE: MR. MICHAEL SANSONE LPC, NCSP, ED.S., MA

MEDICARE: MR. MICHAEL SANSONE LPC, NCSP, ED.S., MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor37PC00473500NJ

General Provider Information

NPI Number : 1982045191
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL SANSONE LPC, NCSP, ED.S., MA
Provider Business Mailing Address
First Line : 108 FAIRWAY TER
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-2321
Country : US
Telephone Number : 856-787-7150
Fax Number : 856-787-1521
Provider Business Practice Location Address
First Line : 108 FAIRWAY TER
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-2321
Country : US
Telephone Number : 856-787-7150
Fax Number : 856-787-1521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2013
Last Update Date : 07/16/2013

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