Provider Demographics
NPI:1770082851
Name:HASSID, SOFIA (LCSW)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:HASSID
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SOFIA
Other - Middle Name:
Other - Last Name:SASOONERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2401 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4808
Mailing Address - Country:US
Mailing Address - Phone:310-279-3590
Mailing Address - Fax:
Practice Address - Street 1:3420 E SHEA BLVD STE 188
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3354
Practice Address - Country:US
Practice Address - Phone:424-465-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA763881041C0700X
AZ168121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical