Provider Demographics
NPI:1235566183
Name:ELFSTROM, SARAH P (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:P
Last Name:ELFSTROM
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 1:6166 LAKE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CAYUGA
Mailing Address - State:NY
Mailing Address - Zip Code:13034-4124
Mailing Address - Country:US
Mailing Address - Phone:315-246-4886
Mailing Address - Fax:
Practice Address - Street 1:6166 LAKE ST APT 3
Practice Address - Street 2:
Practice Address - City:CAYUGA
Practice Address - State:NY
Practice Address - Zip Code:13034-4124
Practice Address - Country:US
Practice Address - Phone:315-246-4886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-08
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080961-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical