Provider Demographics
NPI:1801888789
Name:LASH, SANDRA S (LCSW-R)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:S
Last Name:LASH
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:S
Other - Last Name:KAVNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29 N HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2541
Mailing Address - Country:US
Mailing Address - Phone:845-452-1110
Mailing Address - Fax:845-452-1119
Practice Address - Street 1:223 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2770
Practice Address - Country:US
Practice Address - Phone:845-838-4900
Practice Address - Fax:845-838-4915
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR021103-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR021103-1OtherLCSW-R LICENSE
NYR021103-1OtherLCSW-R LICENSE