Provider Demographics
NPI:1578642724
Name:CALDERON, SANDRA (LCSW, LMFT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 TRAILHEAD LN
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5048
Mailing Address - Country:US
Mailing Address - Phone:914-523-7893
Mailing Address - Fax:
Practice Address - Street 1:245 N BROADWAY
Practice Address - Street 2:SUITE 110
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-2670
Practice Address - Country:US
Practice Address - Phone:914-523-7893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR036336-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN576P1Medicare PIN