Provider Demographics
NPI:1144764903
Name:SARAI LEEB HERMAN PC
Entity Type:Organization
Organization Name:SARAI LEEB HERMAN PC
Other - Org Name:SERENE PSYCHOANALYTICAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEEB-HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:480-272-3513
Mailing Address - Street 1:345 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3714
Mailing Address - Country:US
Mailing Address - Phone:480-272-3513
Mailing Address - Fax:
Practice Address - Street 1:11107 WURZBACH RD
Practice Address - Street 2:SUITE 304
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2500
Practice Address - Country:US
Practice Address - Phone:210-428-5302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX529001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty