Provider Demographics
NPI:1083786438
Name:BRAUCHER, SARAH ANNE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANNE
Last Name:BRAUCHER
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:PO BOX 594
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MA
Mailing Address - Zip Code:01929
Mailing Address - Country:US
Mailing Address - Phone:978-977-2563
Mailing Address - Fax:
Practice Address - Street 1:205 WILLOW ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:SO HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982
Practice Address - Country:US
Practice Address - Phone:978-977-2563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1058761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWASP03855Medicare ID - Type Unspecified