Provider Demographics
NPI:1689702219
Name:SASSER, THOMAS HENRY (LCSW MBA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:HENRY
Last Name:SASSER
Suffix:
Gender:M
Credentials:LCSW MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 NW 159TH LN
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1630
Mailing Address - Country:US
Mailing Address - Phone:954-885-8695
Mailing Address - Fax:
Practice Address - Street 1:1481 SW 81ST AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-4551
Practice Address - Country:US
Practice Address - Phone:954-987-8334
Practice Address - Fax:957-497-3857
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator