Provider Demographics
NPI:1639221773
Name:MCLAUGHLIN, SANDRA MARY (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:MARY
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 OAK ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1219
Mailing Address - Country:US
Mailing Address - Phone:508-951-7751
Mailing Address - Fax:
Practice Address - Street 1:67 BROAD ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4826
Practice Address - Country:US
Practice Address - Phone:508-951-7751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10258791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP07259OtherBLUE CROSS BLUE SHIELD MA
MA550010005448OtherPACIFIC CARE
MA102587OtherTUFTS HEALTH PLAN