Provider Demographics
NPI:1669644829
Name:GUPTA, SARAH RUTH GRATZ (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:RUTH GRATZ
Last Name:GUPTA
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 1:28 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-3305
Mailing Address - Country:US
Mailing Address - Phone:518-810-3589
Mailing Address - Fax:
Practice Address - Street 1:201 CHELMSFORD ST
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2307
Practice Address - Country:US
Practice Address - Phone:978-256-1467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1121971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical