Provider Demographics
NPI:1033408315
Name:STACY SARNOFF, LCSW, PA
Entity Type:Organization
Organization Name:STACY SARNOFF, LCSW, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:SARNOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-796-7080
Mailing Address - Street 1:1515 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 113
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6096
Mailing Address - Country:US
Mailing Address - Phone:954-796-7080
Mailing Address - Fax:954-340-0738
Practice Address - Street 1:1515 N UNIVERSITY DR
Practice Address - Street 2:SUITE 113
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6096
Practice Address - Country:US
Practice Address - Phone:954-796-7080
Practice Address - Fax:954-340-0738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW37311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z6283Medicare UPIN