Provider Demographics
NPI:1316721939
Name:CALE STILL, SANJA (PHD)
Entity type:Individual
Prefix:DR
First Name:SANJA
Middle Name:
Last Name:CALE STILL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SANJA
Other - Middle Name:
Other - Last Name:CALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37 BIRMINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1045
Mailing Address - Country:US
Mailing Address - Phone:631-335-6444
Mailing Address - Fax:
Practice Address - Street 1:410 FORT SALONGA RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-3046
Practice Address - Country:US
Practice Address - Phone:631-262-8561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP121095103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical