Provider Demographics
NPI:1376799452
Name:ROSENBLATT, SARAH KATE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:KATE
Last Name:ROSENBLATT
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 1:1720 W FLORIST AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-3862
Mailing Address - Country:US
Mailing Address - Phone:414-247-0801
Mailing Address - Fax:414-247-0816
Practice Address - Street 1:1720 W FLORIST AVE STE 125
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-3862
Practice Address - Country:US
Practice Address - Phone:414-247-0801
Practice Address - Fax:414-247-0816
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7271104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40958100Medicaid