Healthcare Provider Details

I. General information

NPI: 1588478911
Provider Name (Legal Business Name): SANDRA MARIE TEIXEIRA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 NORTH ST STE 34
PITTSFIELD MA
01201-5149
US

IV. Provider business mailing address

PO BOX 2432
PITTSFIELD MA
01202-2432
US

V. Phone/Fax

Practice location:
  • Phone: 833-623-9750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2120819
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: