Provider Demographics
NPI:1801866652
Name:SARTEN, SANDRA K (LCSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:SARTEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367B N PARKWAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2865
Mailing Address - Country:US
Mailing Address - Phone:731-668-2277
Mailing Address - Fax:731-660-0510
Practice Address - Street 1:367B N PARKWAY
Practice Address - Street 2:SUITE 1
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2865
Practice Address - Country:US
Practice Address - Phone:731-668-2277
Practice Address - Fax:731-660-0510
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN149694OtherBLUE CROSS BLUE SHIELD