Sandra Dee Baker, LMSW

Individual provider Active NPI Clinical Social Worker · South Windsor, CT

NPI 1386413490 · NPPES record last updated Dec 29, 2023

Key facts

NPI
1386413490
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
9373 (CT)
Practice address
90 Lisa Dr
South Windsor, CT 06074-1836
Phone
(860) 461-6695
NPI assigned
Dec 29, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9373CTMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9373 CT Yes

Addresses

Primary practice location

90 Lisa Dr
South Windsor, CT 06074-1836

Mailing address

90 Lisa Dr
South Windsor, CT 06074-1836
Phone (860) 461-6695

Other names

  • Miss Sandra Dee Fulgham Former name

Other providers in South Windsor, CT

All providers in South Windsor, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.