Healthcare Provider Details

I. General information

NPI: 1811125792
Provider Name (Legal Business Name): SARAH PATTON LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

286 MONTAGUE RD
SHUTESBURY MA
01072-9760
US

IV. Provider business mailing address

286 MONTAGUE RD
SHUTESBURY MA
01072-9760
US

V. Phone/Fax

Practice location:
  • Phone: 413-259-0030
  • Fax:
Mailing address:
  • Phone: 413-259-0030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1026223
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: