Healthcare Provider Details

I. General information

NPI: 1346065885
Provider Name (Legal Business Name): SARAH CRANMER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11811 N TATUM BLVD STE 3031
PHOENIX AZ
85028-1621
US

IV. Provider business mailing address

6735 E GREENWAY PKWY APT 2156
SCOTTSDALE AZ
85254-2117
US

V. Phone/Fax

Practice location:
  • Phone: 773-706-8981
  • Fax:
Mailing address:
  • Phone: 630-818-7001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-21169
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: