Provider Demographics
NPI:1780716399
Name:CHATBURN, SADIE JOANN (LISW)
Entity type:Individual
Prefix:MS
First Name:SADIE
Middle Name:JOANN
Last Name:CHATBURN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:SADIE
Other - Middle Name:JOANN
Other - Last Name:SHERLING CHATBURN, GARDNER, SHERBUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2020 LAKE HEIGHTS DR APT B202
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6037
Mailing Address - Country:US
Mailing Address - Phone:425-405-8280
Mailing Address - Fax:
Practice Address - Street 1:5802 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2706
Practice Address - Country:US
Practice Address - Phone:206-323-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC60779078101Y00000X
WARC#00049894101YM0800X
WALW61351551104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health