Provider Demographics
NPI:1235936709
Name:BIGHAM, SALLY (LCSW)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:BIGHAM
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 LUCERNE AVE UNIT 147
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3832
Mailing Address - Country:US
Mailing Address - Phone:615-878-2167
Mailing Address - Fax:
Practice Address - Street 1:4802 EAST AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2426
Practice Address - Country:US
Practice Address - Phone:561-710-2000
Practice Address - Fax:561-710-2772
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW230261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical