Individual provider Active NPI

Sandra K Saville, LCSW-C

  • Clinical Social Worker
  • Eldersburg, MD
National Provider Identifier
1104081983
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09622 Issued in MD
Practice address
6190 Georgetown Blvd
Suite 105
Eldersburg, MD 21784-6460
Phone
(410) 552-9004
Fax
(410) 552-4267
NPI assigned
Jul 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 09622 MD Primary

Addresses

Primary practice location

6190 Georgetown Blvd
Suite 105
Eldersburg, MD 21784-6460

Mailing address

6190 Georgetown Blvd
Suite 105
Eldersburg, MD 21784-6460
Phone (410) 552-9004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
09622MDMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1104081983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6190 GEORGETOWN BLVD",
            "address_2": "SUITE 105",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846460",
            "telephone_number": "410-552-9004",
            "fax_number": "410-552-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6190 GEORGETOWN BLVD",
            "address_2": "SUITE 105",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846460",
            "telephone_number": "410-552-9004",
            "fax_number": "410-552-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAVILLE",
        "first_name": "SANDRA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.