Provider Demographics
NPI:1740431717
Name:SASPORTAS, MICHAEL M (MSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:SASPORTAS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ESTERLY FARMS RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2279
Mailing Address - Country:US
Mailing Address - Phone:860-874-1042
Mailing Address - Fax:
Practice Address - Street 1:190 WESTBROOK RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426-1518
Practice Address - Country:US
Practice Address - Phone:860-767-0147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical