Provider Demographics
NPI:1285023408
Name:KAUTZ, SARAH (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KAUTZ
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 1:108 FAIRWAY TERRACE
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6314
Mailing Address - Country:US
Mailing Address - Phone:856-787-7150
Mailing Address - Fax:
Practice Address - Street 1:108 FAIRWAY TER
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2321
Practice Address - Country:US
Practice Address - Phone:856-787-7150
Practice Address - Fax:856-787-1521
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0170371041C0700X
PACW0188851041C0700X
NJ44SC056553001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical