Provider Demographics
NPI:1184866683
Name:KATHLEEN G. SAWLER, LICSW, LLC
Entity Type:Organization
Organization Name:KATHLEEN G. SAWLER, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:GALLAGHER
Authorized Official - Last Name:SAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-767-2110
Mailing Address - Street 1:34 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-2147
Mailing Address - Country:US
Mailing Address - Phone:603-767-2110
Mailing Address - Fax:
Practice Address - Street 1:1 GREENLEAF WOODS DR
Practice Address - Street 2:#302
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5437
Practice Address - Country:US
Practice Address - Phone:603-767-2110
Practice Address - Fax:603-431-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH955261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30424069Medicaid