Provider Demographics
NPI:1477678944
Name:EMERSON, SARA J (MSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:J
Last Name:EMERSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-3337
Mailing Address - Country:US
Mailing Address - Phone:617-547-7037
Mailing Address - Fax:
Practice Address - Street 1:30 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-3337
Practice Address - Country:US
Practice Address - Phone:617-547-7037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1028321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO1232OtherBCBS
MAPO1232OtherNHIC