Provider Demographics
NPI:1457463978
Name:CARLSON, SANDRA A (MSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:A
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:A
Other - Last Name:SALVESEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456
Mailing Address - Country:US
Mailing Address - Phone:973-556-5434
Mailing Address - Fax:973-383-9309
Practice Address - Street 1:11 SUNSET RD
Practice Address - Street 2:
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456
Practice Address - Country:US
Practice Address - Phone:973-962-4425
Practice Address - Fax:973-383-9309
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00168800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker