Provider Demographics
NPI:1467400812
Name:TROSTY WALSH, SARA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:TROSTY WALSH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:TROSTY JENSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:5841 CORPORATE WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407
Mailing Address - Country:US
Mailing Address - Phone:561-684-1991
Mailing Address - Fax:561-684-8582
Practice Address - Street 1:5841 CORPORATE WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2039
Practice Address - Country:US
Practice Address - Phone:561-684-1991
Practice Address - Fax:561-828-9272
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW79831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ091COtherBCBS FL
FLZ091COtherBCBS FL