Provider Demographics
NPI:1184014136
Name:SANFORD, LINDA T (LICSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:T
Last Name:SANFORD
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 1:49 HEATHERLAND RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON HIGHLANDS
Mailing Address - State:MA
Mailing Address - Zip Code:02461-2139
Mailing Address - Country:US
Mailing Address - Phone:617-699-1511
Mailing Address - Fax:617-916-0217
Practice Address - Street 1:129 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6497
Practice Address - Country:US
Practice Address - Phone:617-699-1511
Practice Address - Fax:617-232-1987
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1033671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical