Provider Demographics
NPI:1609164631
Name:HANSBOROUGH, SANDY (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:
Last Name:HANSBOROUGH
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 KATE WAGNER RD
Mailing Address - Street 2:CARROLL PLAZA SHOPPING CENTER
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6957
Mailing Address - Country:US
Mailing Address - Phone:410-848-2500
Mailing Address - Fax:410-876-3016
Practice Address - Street 1:250 ENGLAR RD STE 3
Practice Address - Street 2:CARROLL PLAZA SHOPPING CENTER
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-2927
Practice Address - Country:US
Practice Address - Phone:410-615-3469
Practice Address - Fax:800-251-0179
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD159131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical