Provider Demographics
NPI:1396232021
Name:BASHEIN, SARAH JILL
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JILL
Last Name:BASHEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CAPONE RD
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-3303
Mailing Address - Country:US
Mailing Address - Phone:339-364-1157
Mailing Address - Fax:
Practice Address - Street 1:101 VANDERBILT AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5011
Practice Address - Country:US
Practice Address - Phone:339-364-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50081688104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker