Provider Demographics
NPI:1124606280
Name:SAWYER, CRYSTAL MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:MARIE
Last Name:SAWYER
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 1:11 SMITH TER
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14504-9766
Mailing Address - Country:US
Mailing Address - Phone:585-662-7733
Mailing Address - Fax:
Practice Address - Street 1:11 SMITH TER
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14504-9766
Practice Address - Country:US
Practice Address - Phone:585-662-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0896861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical