MEDICARE: SARA J BATCHELDER 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	004042	CT

General Provider Information

NPI Number	:	1194939934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA J BATCHELDER LCSW

Provider Business Mailing Address
First Line	:	10 MATHERS XING
Second Line	:
City	:	SIMSBURY
State	:	CT
Zip	:	06070-2478
Country	:	US
Telephone Number	:	860-727-8703
Fax Number	:	860-548-2045

Provider Business Practice Location Address
First Line	:	1 MAIN ST
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06106-1806
Country	:	US
Telephone Number	:	860-727-8703
Fax Number	:	860-548-2045

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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