Provider Demographics
NPI:1336692136
Name:CIRBA, SARA M (MPA, LMSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:CIRBA
Suffix:
Gender:F
Credentials:MPA, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:NY
Mailing Address - Zip Code:13856-1454
Mailing Address - Country:US
Mailing Address - Phone:607-832-5888
Mailing Address - Fax:607-865-7424
Practice Address - Street 1:1 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:NY
Practice Address - Zip Code:13856-1454
Practice Address - Country:US
Practice Address - Phone:607-832-5888
Practice Address - Fax:607-865-7424
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097280104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker