MEDICARE: MS. STEPHANIE C SANGER

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
2	104100000X	Social Worker	SW129545	PA

General Provider Information

NPI Number	:	1952669673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE C SANGER

Provider Business Mailing Address
First Line	:	716 GROVE ST
Second Line	:
City	:	HADDONFIELD
State	:	NJ
Zip	:	08033-1050
Country	:	US
Telephone Number	:	856-298-9087
Fax Number	:

Provider Business Practice Location Address
First Line	:	1518 WAVERLY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-1633
Country	:	US
Telephone Number	:	856-520-7984
Fax Number	:

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

Provider Enumeration Date	:	05/01/2012
Last Update Date	:	05/06/2021

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Directions to “ MS. STEPHANIE C SANGER ” Practice Location

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