Provider Demographics
NPI:1114462983
Name:SARDI, SHAUNA R (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:SHAUNA
Middle Name:R
Last Name:SARDI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 MAGEE DR
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1340
Mailing Address - Country:US
Mailing Address - Phone:475-282-1060
Mailing Address - Fax:
Practice Address - Street 1:196 MAGEE DR
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1340
Practice Address - Country:US
Practice Address - Phone:475-282-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT90971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical