Provider Demographics
NPI:1275554644
Name:MADRUGA, SANDRA J (MS LMHC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:J
Last Name:MADRUGA
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2236
Mailing Address - Country:US
Mailing Address - Phone:603-893-9984
Mailing Address - Fax:978-359-2208
Practice Address - Street 1:24 GEORGETOWN ROAD
Practice Address - Street 2:A CLEARLIGHT CENTER, INC.
Practice Address - City:BOXFORD
Practice Address - State:MA
Practice Address - Zip Code:01921
Practice Address - Country:US
Practice Address - Phone:978-887-2977
Practice Address - Fax:978-359-2208
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1983101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health