MEDICARE: MICHAEL SUGAR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW020427	PA

General Provider Information

NPI Number	:	1023495926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SUGAR LCSW

Provider Business Mailing Address
First Line	:	218 N PINE ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3435
Country	:	US
Telephone Number	:	410-707-3919
Fax Number	:	171-722-2524

Provider Business Practice Location Address
First Line	:	218 N PINE ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3435
Country	:	US
Telephone Number	:	410-707-3919
Fax Number	:	171-722-2524

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2015
Last Update Date	:	02/14/2024

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