Provider Demographics
NPI:1740910199
Name:SANFORD, GEOFFREY LLOYD (MS)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:LLOYD
Last Name:SANFORD
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 PHILLIPS AVE # B2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2251
Mailing Address - Country:US
Mailing Address - Phone:216-406-5457
Mailing Address - Fax:
Practice Address - Street 1:225 PENN AVE
Practice Address - Street 2:
Practice Address - City:WILKINSBURG
Practice Address - State:PA
Practice Address - Zip Code:15221-2148
Practice Address - Country:US
Practice Address - Phone:412-864-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)