Provider Demographics
NPI:1225409865
Name:FINE-DORSKY, SARA E (MSW,BSW,LMSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:FINE-DORSKY
Suffix:
Gender:F
Credentials:MSW,BSW,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:WATERBURY CLINICAL SERVICES
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2310
Practice Address - Country:US
Practice Address - Phone:203-574-9000
Practice Address - Fax:203-574-9006
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2194104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTNOT ELIGIBLEOtherMHN-MANAGED HEALTH NETWORK
CT060669107OtherUBH-OXFORD FREEDOM/LIBERTY -WELLMORE GRP/FACILITY
CT060669107OtherUBH-UNITED HEALTHCARE- WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN-TRICARE NORTH
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT060669107OtherHEALTHYCT - WELLMORE GRP/FACILITY
CT060669107OtherANTHEM BCBS OF CT - WELLMORE GRP/FACILITY
CT060669107OtherUNITED BEHAVIORAL HEALTH-WELLMORE GRP/FACILITY
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherUBH-CONNECTICARE- WELLMORE GRP/FACILITY
CT008062531Medicaid
CT13671434OtherCAQH
CTD339209-WATERBURYOtherVALLUE OPTIONS
CTNOT ELIGIBLEOtherMHN-MANAGED HEALTH NETWORK