Provider Demographics
NPI:1962736751
Name:PACKARD, SARAH V (LICSW)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:V
Last Name:PACKARD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HIGHLAND VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1123
Mailing Address - Country:US
Mailing Address - Phone:860-460-0854
Mailing Address - Fax:
Practice Address - Street 1:11 HIGHLAND VIEW AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1123
Practice Address - Country:US
Practice Address - Phone:860-460-0854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD203301041C0700X
MA1145241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical