MEDICARE: MARIE SOPHIA SANON LMSW, CASAC-T

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	130193	NY

General Provider Information

NPI Number	:	1447114269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE SOPHIA SANON LMSW, CASAC-T

Provider Business Mailing Address
First Line	:	245 HAWTHORNE ST APT D8
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-5980
Country	:	US
Telephone Number	:	347-528-5934
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 HAWTHORNE ST APT D8
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-5980
Country	:	US
Telephone Number	:	347-528-5934
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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