Provider Demographics
NPI:1457142796
Name:BURROWS-RUTBERG, SARAH BLANCHARD (LMSW-CC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BLANCHARD
Last Name:BURROWS-RUTBERG
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-4206
Mailing Address - Country:US
Mailing Address - Phone:207-613-2470
Mailing Address - Fax:
Practice Address - Street 1:963 BROADWAY
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-4206
Practice Address - Country:US
Practice Address - Phone:207-613-2470
Practice Address - Fax:207-629-3496
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC241621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical