Provider Demographics
NPI:1871155077
Name:OSPINA, SASHA VANESSA (LMSW)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:VANESSA
Last Name:OSPINA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3224
Mailing Address - Country:US
Mailing Address - Phone:269-993-3428
Mailing Address - Fax:
Practice Address - Street 1:424 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3224
Practice Address - Country:US
Practice Address - Phone:269-993-3428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010941911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical