Healthcare Provider Details

I. General information

NPI: 1437272937
Provider Name (Legal Business Name): SARAHLEE SEWARDS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 TIDEWINDS TER
MARBLEHEAD MA
01945-1339
US

IV. Provider business mailing address

5 TIDEWINDS TER
MARBLEHEAD MA
01945-1339
US

V. Phone/Fax

Practice location:
  • Phone: 617-699-8137
  • Fax:
Mailing address:
  • Phone: 617-699-8137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number211930
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number115756
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: