=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124155510
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN KNAUER SARTIN L.C.S.W
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2007
-----------------------------------------------------
Last Update Date | 12/21/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 N BROAD ST
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19709-1037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-376-0621
-----------------------------------------------------
Fax | 302-376-6219
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 268 BRENFORD STATION RD
-----------------------------------------------------
City | SMYRNA
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19977-4612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-659-5470
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | Q1-0000940
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------