MEDICARE: MISS SARA E. EVERY L.C.S.W.

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	44SC05235300	NJ

General Provider Information

NPI Number	:	1861608697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SARA E. EVERY L.C.S.W.

Provider Business Mailing Address
First Line	:	969 BLOOMFIELD AVE
Second Line	:	APT. C-3
City	:	GLEN RIDGE
State	:	NJ
Zip	:	07028-1327
Country	:	US
Telephone Number	:	973-655-0020
Fax Number	:

Provider Business Practice Location Address
First Line	:	969 BLOOMFIELD AVE
Second Line	:	APT. C-3
City	:	GLEN RIDGE
State	:	NJ
Zip	:	07028-1327
Country	:	US
Telephone Number	:	973-985-0651
Fax Number	:

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	06/21/2010

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