Provider Demographics
NPI:1982845780
Name:KAUFMAN, SANDRA PAULA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:PAULA
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:PAULA
Other - Last Name:TZODIKOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:50 W MONTGOMERY AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4216
Mailing Address - Country:US
Mailing Address - Phone:301-251-8965
Mailing Address - Fax:301-251-0136
Practice Address - Street 1:50 W MONTGOMERY AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4216
Practice Address - Country:US
Practice Address - Phone:301-251-8965
Practice Address - Fax:301-251-0136
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05937170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS