Provider Demographics
NPI:1538759659
Name:SADOK, TAMARA MAXINE (LICSW)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:MAXINE
Last Name:SADOK
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 1:41 EDWARDEL RD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-4001
Mailing Address - Country:US
Mailing Address - Phone:781-844-8782
Mailing Address - Fax:
Practice Address - Street 1:100 CENTRE ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-2805
Practice Address - Country:US
Practice Address - Phone:617-363-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA115314104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker