Provider Demographics
NPI:1073178489
Name:MAY, SARA JEAN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:JEAN
Last Name:MAY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 WAITE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-2559
Mailing Address - Country:US
Mailing Address - Phone:413-284-7764
Mailing Address - Fax:413-304-3993
Practice Address - Street 1:141 WAITE AVE
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-2559
Practice Address - Country:US
Practice Address - Phone:413-284-7764
Practice Address - Fax:413-304-3993
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2226411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical