Provider Demographics
NPI:1790252245
Name:ANDERSON, SARAH (APSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 W WASHINGTON AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3007
Mailing Address - Country:US
Mailing Address - Phone:608-280-2095
Mailing Address - Fax:
Practice Address - Street 1:345 W WASHINGTON AVE STE 501
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3007
Practice Address - Country:US
Practice Address - Phone:608-280-2095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131119-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker