Provider Demographics
NPI:1518182443
Name:EISNER, SANDRA D (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:D
Last Name:EISNER
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 1:7100 CAMINO REAL STE 123
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5510
Mailing Address - Country:US
Mailing Address - Phone:561-487-4842
Mailing Address - Fax:561-391-5054
Practice Address - Street 1:7100 CAMINO REAL STE 123
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433
Practice Address - Country:US
Practice Address - Phone:561-487-4842
Practice Address - Fax:561-391-5054
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW17891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical