Provider Demographics
NPI:1295940039
Name:SCHENKAR, SANDRA FORD (MSW BCD LICSW)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:FORD
Last Name:SCHENKAR
Suffix:
Gender:F
Credentials:MSW BCD LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 KLAHANIE DR NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502
Mailing Address - Country:US
Mailing Address - Phone:360-866-4254
Mailing Address - Fax:360-866-6513
Practice Address - Street 1:905 24TH WAY SW
Practice Address - Street 2:SUITE A1
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-709-3332
Practice Address - Fax:360-709-3336
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000054251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY38OtherCSW
WA8906639OtherDEPT L & I
NASWOtherBOARD CERTIFIED DIPLOMATE
KY38OtherCSW