Provider Demographics
NPI:1497274708
Name:SANZARI, MEGHAN (LICSW)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:SANZARI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:RAIMONDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:881 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1390
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:881 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1390
Practice Address - Country:US
Practice Address - Phone:617-358-2818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1199691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical