Provider Demographics
NPI:1013039247
Name:OPPENHEIMER, SARA ALICE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:ALICE
Last Name:OPPENHEIMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 JEFFERSON RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3415
Mailing Address - Country:US
Mailing Address - Phone:609-924-5793
Mailing Address - Fax:
Practice Address - Street 1:22 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6813
Practice Address - Country:US
Practice Address - Phone:609-924-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014627001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ651913BN3Medicare ID - Type Unspecified