Provider Demographics
NPI:1114051026
Name:WHITE, SARAH S (LCSW, CASAC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:S
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MILES AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3117
Mailing Address - Country:US
Mailing Address - Phone:315-474-3707
Mailing Address - Fax:315-479-5410
Practice Address - Street 1:201 MILES AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-3117
Practice Address - Country:US
Practice Address - Phone:315-474-3707
Practice Address - Fax:315-479-5410
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASAC1721101YA0400X
NYRP014516-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical