Healthcare Provider Details

I. General information

NPI: 1447916812
Provider Name (Legal Business Name): SARAH ANN CIMAGLIA LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ANN MATRISCIANO

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 CHURCH ST
NEW BEDFORD MA
02745-1400
US

IV. Provider business mailing address

16 SEAVIEW AVE
FAIRHAVEN MA
02719-2308
US

V. Phone/Fax

Practice location:
  • Phone: 508-996-8572
  • Fax:
Mailing address:
  • Phone: 508-951-0483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000227450
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: