Healthcare Provider Details

I. General information

NPI: 1144704099
Provider Name (Legal Business Name): SARAH JANE KILLION MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 INDUSTRIAL DR
NORTHAMPTON MA
01060-2379
US

IV. Provider business mailing address

168 INDUSTRIAL DR
NORTHAMPTON MA
01060-2379
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-1060
  • Fax:
Mailing address:
  • Phone: 413-584-1060
  • Fax: 413-584-9615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number106116
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: