Healthcare Provider Details

I. General information

NPI: 1841701695
Provider Name (Legal Business Name): SARAH MCNALLY LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 10/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

273 OAK GROVE AVE
FALL RIVER MA
02723-2315
US

IV. Provider business mailing address

85 GRANGE PARK
BRIDGEWATER MA
02324-2393
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-4866
  • Fax:
Mailing address:
  • Phone: 508-345-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: