Provider Demographics
NPI:1922161934
Name:BARLOW, SANDRA M (LCSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:BARLOW
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 1:2888 MAHAN DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5464
Mailing Address - Country:US
Mailing Address - Phone:850-577-9077
Mailing Address - Fax:850-681-0284
Practice Address - Street 1:2888 MAHAN DR
Practice Address - Street 2:SUITE 1
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5464
Practice Address - Country:US
Practice Address - Phone:850-577-9077
Practice Address - Fax:850-681-0284
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW40751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ7033OtherBCBS