Provider Demographics
NPI:1043301260
Name:WILLS, SARAH HART (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:HART
Last Name:WILLS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:HART
Other - Last Name:WILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:20 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3784
Mailing Address - Country:US
Mailing Address - Phone:603-357-3400
Mailing Address - Fax:603-357-6859
Practice Address - Street 1:20 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3784
Practice Address - Country:US
Practice Address - Phone:603-357-3400
Practice Address - Fax:603-357-6859
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH902104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker