Provider Demographics
NPI:1013039536
Name:LOCKHART-PALLADINO, SARAH E (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:LOCKHART-PALLADINO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BAY ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2306
Mailing Address - Country:US
Mailing Address - Phone:518-480-4422
Mailing Address - Fax:518-636-5184
Practice Address - Street 1:185 BAY ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-2306
Practice Address - Country:US
Practice Address - Phone:518-480-4422
Practice Address - Fax:518-636-5184
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076461-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY076461-1OtherUNIVERSITY OF NY LICENSE
NYJ400043593Medicare PIN