Provider Demographics
NPI:1689147753
Name:GARTAGANIS, SARAH LYN (LICSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYN
Last Name:GARTAGANIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LYN
Other - Last Name:DOWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:37 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-4412
Mailing Address - Country:US
Mailing Address - Phone:603-707-0105
Mailing Address - Fax:
Practice Address - Street 1:37 HARDING AVE
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-4412
Practice Address - Country:US
Practice Address - Phone:603-707-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1197571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical