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Contact Information

SALLY A PRIMUS, MSW, LCSW
3176 LANCER ST
SUITE 501
PORTAGE, IN46368
 Phone: 219-762-9557
 Fax: 219-762-7318
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for SALLY A PRIMUS · (Female)

NPI Number 1225228828
Status Active
Credentials MSW, LCSW
Entity Individual
Enumeration date 07/30/2007
Last updated 07/27/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 34006144A
  • IN License # 99027928A
  • IN Medicaid 10016380A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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