Provider Demographics
NPI:1821293622
Name:CARPENTER, SARAH (LCSW 17820)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LCSW 17820
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GORHAM RD # 2
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2272
Mailing Address - Country:US
Mailing Address - Phone:707-287-2449
Mailing Address - Fax:
Practice Address - Street 1:2 COURTHOUSE LN STE 3
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1723
Practice Address - Country:US
Practice Address - Phone:978-275-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1177851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical