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General NPI Number Information
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NPI Number | 1023387305
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Entity Type | Individual
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Provider Name | SARAH ELIZABETH ANDERSON M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 306 WEST 5TH AVE.
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City | NOME
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State | AK
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Zip | 99762
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Country | US
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Telephone | 907-443-4525
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Fax | 907-443-2085
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Provider Business Mailing Address
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Address Line | 306 WEST 5TH AVENUE P.O. BOX 966
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City | NOME
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State | AK
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Zip | 99762
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Country | US
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Telephone | 907-443-4525
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Fax | 907-443-2085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801093207
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-17735
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License Number State | AZ
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