Organization
SOUTH BAY MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN HELEN SANFORD LICSW (CLINICAL SOCIAL WORKER)
(508) 830-0000
Entity
Organization
Contact information
Practice address
50 ALDRIN RD, PLYMOUTH, MA 02360-4827
(508) 830-0000
(508) 746-8429
Mailing address
50 ALDRIN RD, PLYMOUTH, MA 02360-4827
(508) 830-0000
(508) 746-8429
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1026901
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026901
COMMONWEALTH OF MASSACHUSETTS/ SOCIAL WORKER/ LICSW
MA
Enumeration date
07/06/2012
Last updated
07/06/2012
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