Provider Demographics
NPI:1124214119
Name:SARTER, MADELINE VERONICA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:VERONICA
Last Name:SARTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:MADELINE
Other - Middle Name:VERONICA
Other - Last Name:SARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:9953 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3949
Mailing Address - Country:US
Mailing Address - Phone:718-641-1991
Mailing Address - Fax:
Practice Address - Street 1:800 POLY PL # 122
Practice Address - Street 2:BROOKLYN,
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:718-630-2950
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076077-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker