Provider Demographics
NPI:1811310881
Name:SANDFORD, JEANMARIE LIKAR (PSYD)
Entity type:Individual
Prefix:DR
First Name:JEANMARIE
Middle Name:LIKAR
Last Name:SANDFORD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10590-1615
Mailing Address - Country:US
Mailing Address - Phone:914-282-2298
Mailing Address - Fax:
Practice Address - Street 1:215 KATONAH AVE
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2138
Practice Address - Country:US
Practice Address - Phone:914-282-2298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022094103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical