Provider Demographics
NPI:1811453913
Name:CAROLYN SASS LCSW LLC
Entity type:Organization
Organization Name:CAROLYN SASS LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SASS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-245-0077
Mailing Address - Street 1:15 MAIN ST STE 16
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-1164
Mailing Address - Country:US
Mailing Address - Phone:207-245-0077
Mailing Address - Fax:
Practice Address - Street 1:15 MAIN ST STE 16
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-1164
Practice Address - Country:US
Practice Address - Phone:207-245-0077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health