Provider Demographics
NPI:1447821483
Name:SANGER, MONA (LICSW)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:SANGER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 42ND AVE SW APT 515
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-5848
Mailing Address - Country:US
Mailing Address - Phone:503-953-3470
Mailing Address - Fax:
Practice Address - Street 1:4502 42ND AVE SW APT 515
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-5848
Practice Address - Country:US
Practice Address - Phone:503-953-3470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609079651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty