Provider Demographics
NPI:1154617090
Name:LOOMIS, SANDRA A (LMHC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:LOOMIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 ARMSBY RD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-2938
Mailing Address - Country:US
Mailing Address - Phone:603-703-6324
Mailing Address - Fax:
Practice Address - Street 1:145 ARMSBY RD
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:MA
Practice Address - Zip Code:01590-2938
Practice Address - Country:US
Practice Address - Phone:603-703-6324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health