Provider Demographics
NPI:1235272063
Name:SARRIS, ANTONIA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ANTONIA
Middle Name:
Last Name:SARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CHAPEL ST
Mailing Address - Street 2:SUITE 903
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1952
Mailing Address - Country:US
Mailing Address - Phone:718-875-7510
Mailing Address - Fax:718-858-8410
Practice Address - Street 1:25 CHAPEL ST
Practice Address - Street 2:SUITE 903
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1952
Practice Address - Country:US
Practice Address - Phone:718-875-7510
Practice Address - Fax:718-858-8410
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0789511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical