Provider Demographics
NPI:1932132842
Name:STEVENSON, SARAH JAYE (LICSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JAYE
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SANTUIT POND WAY UNIT 12D
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-2447
Mailing Address - Country:US
Mailing Address - Phone:508-681-9471
Mailing Address - Fax:
Practice Address - Street 1:35 SANTUIT POND WAY UNIT 12D
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-2447
Practice Address - Country:US
Practice Address - Phone:508-681-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health