| Clayton D. Sankey Licsw, Llc | |
|
2127 County Road D E Ste A100 Maplewood MN 55109-5350 | |
| (651) 770-0355 | |
| (651) 770-0529 |
| Full Name | Clayton D. Sankey Licsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2127 County Road D E Ste A100, Maplewood, Minnesota |
| Authorized Official Name and Position | Clayton D Sankey (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6517700355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clayton D. Sankey Licsw, Llc 6484 Kings Dr Oakdale MN 55128-2523 Ph: (651) 770-0355 | Clayton D. Sankey Licsw, Llc 2127 County Road D E Ste A100 Maplewood MN 55109-5350 Ph: (651) 770-0355 |
| NPI Number | 1023097185 |
|---|---|
| Provider Enumeration Date | 01/16/2006 |
| Last Update Date | 04/20/2018 |
| Medicare PECOS PAC ID | 7911962907 |
|---|---|
| Medicare Enrollment ID | O20041201000810 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023097185 | NPI | - | NPPES |
| 454048400 | Medicaid | MN | |
| 00097 | Other | MN | LICSW LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 00097 (Minnesota) | Primary |
| Provider Name | Clayton David Sankey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003863531 PECOS PAC ID: 9032172879 Enrollment ID: I20041111000728 |
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