Provider Demographics
NPI:1326009127
Name:ZAIENTZ, SARA G (LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:G
Last Name:ZAIENTZ
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:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498-0918
Mailing Address - Country:US
Mailing Address - Phone:860-399-9239
Mailing Address - Fax:860-358-3403
Practice Address - Street 1:1163 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-1947
Practice Address - Country:US
Practice Address - Phone:860-882-7032
Practice Address - Fax:860-358-3403
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0058361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT005836OtherLCSW CT LIC #