Provider Demographics
NPI:1376978569
Name:ANDERSON, SARAH W (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:W
Last Name:ANDERSON
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 1:174 PANAEWA ST
Mailing Address - Street 2:APT A
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3871
Mailing Address - Country:US
Mailing Address - Phone:615-306-8314
Mailing Address - Fax:808-238-0207
Practice Address - Street 1:174 PANAEWA ST
Practice Address - Street 2:APT A
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3871
Practice Address - Country:US
Practice Address - Phone:615-306-8314
Practice Address - Fax:808-238-0207
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN92211041C0700X
HI44031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical