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Provider Information for 1689717506


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JUDITH ANN SACHS LCSW


Sex: Female

NPI: 1689717506
Last Updated: 2008-03-12
Certification Date:

Details

NameValue
NPI1689717506
Enumeration Date2007-02-14
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 14011 SHADY SHORES DR
TAMPA, FL 33613-1932
United States

Phone: 813-205-8153 | Fax:727-479-1248
 
Primary Practice Address 14041 ICOT BLVD
CLEARWATER, FL 33760-3702
United States

Phone: 727-479-1800 | Fax:727-479-1248
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDFL768029500
Other (non-Medicare)FLAG421ZFIRST COAST - MEDICARE B
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalFLSW 8396