Provider Demographics
NPI:1134687650
Name:TOMAKICH, SARAH JANE (LMSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:TOMAKICH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 E MICHIGAN AVE STE 223
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-4005
Mailing Address - Country:US
Mailing Address - Phone:231-534-5432
Mailing Address - Fax:
Practice Address - Street 1:2722 E MICHIGAN AVE STE 223
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4005
Practice Address - Country:US
Practice Address - Phone:315-345-4322
Practice Address - Fax:810-215-1334
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011036531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical