Provider Demographics
NPI:1093987489
Name:NOONE, SARA LEE-CONROY (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:LEE-CONROY
Last Name:NOONE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SOUTH ST.
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143
Mailing Address - Country:US
Mailing Address - Phone:617-284-5130
Mailing Address - Fax:617-591-0239
Practice Address - Street 1:111 SOUTH ST.
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143
Practice Address - Country:US
Practice Address - Phone:617-284-5130
Practice Address - Fax:617-591-0239
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214294104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker