Provider Demographics
NPI:1396094389
Name:SAVARIEGO, SANDRA L (LCSW)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:SAVARIEGO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PINE LAKES PKWY N
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3643
Mailing Address - Country:US
Mailing Address - Phone:386-447-4145
Mailing Address - Fax:
Practice Address - Street 1:2 PINE LAKES PKWY N
Practice Address - Street 2:SUITE 6
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3643
Practice Address - Country:US
Practice Address - Phone:386-447-4145
Practice Address - Fax:386-447-2827
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW19391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical