Provider Demographics
NPI:1407071418
Name:LOVERDI, SARAH ANN (LCSW-R)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:LOVERDI
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 AYRAULT RD
Mailing Address - Street 2:SUITE#6
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-8962
Mailing Address - Country:US
Mailing Address - Phone:585-764-5459
Mailing Address - Fax:
Practice Address - Street 1:815 AYRAULT RD
Practice Address - Street 2:SUITE#6
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-8962
Practice Address - Country:US
Practice Address - Phone:585-764-5459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR056010-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY121905FKOtherPREFERRED CARE ID