Provider Demographics
NPI:1255485835
Name:SACKS, STEVEN (LCSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SACKS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1908
Mailing Address - Country:US
Mailing Address - Phone:516-876-2628
Mailing Address - Fax:
Practice Address - Street 1:36 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-1908
Practice Address - Country:US
Practice Address - Phone:516-876-2628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02343411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical