Healthcare Provider Details

I. General information

NPI: 1942297957
Provider Name (Legal Business Name): SARAH LOUISE CLAYTON LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 WINSOR ST SUITE 101
LUDLOW MA
01056-3469
US

IV. Provider business mailing address

77 WINSOR ST SUITE 101
LUDLOW MA
01056-3469
US

V. Phone/Fax

Practice location:
  • Phone: 413-583-6750
  • Fax: 413-589-7001
Mailing address:
  • Phone: 413-583-6750
  • Fax: 413-589-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107293
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: