Provider Demographics
NPI:1013235738
Name:BEAUVOIR, SANDY C (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:C
Last Name:BEAUVOIR
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:MS
Other - First Name:SANDY
Other - Middle Name:C
Other - Last Name:CHRISTOPHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW, MSW
Mailing Address - Street 1:867 BOYLSTON ST
Mailing Address - Street 2:5TH FLOOR #1522
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2774
Mailing Address - Country:US
Mailing Address - Phone:617-444-9098
Mailing Address - Fax:
Practice Address - Street 1:867 BOYLSTON ST FL 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2774
Practice Address - Country:US
Practice Address - Phone:617-444-9098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1170501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical