Provider Demographics
NPI:1437486305
Name:MATHEWS DIXON, SARA MARIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARIA
Last Name:MATHEWS DIXON
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 1:36 OLD KINGS HIGHWAY SOUTH
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820
Mailing Address - Country:US
Mailing Address - Phone:203-636-0080
Mailing Address - Fax:203-636-0080
Practice Address - Street 1:36 OLD KINGS HWY S
Practice Address - Street 2:SUITE 210
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4552
Practice Address - Country:US
Practice Address - Phone:203-636-0080
Practice Address - Fax:203-636-0080
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0066061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical