Provider Demographics
NPI:1568220325
Name:HERMAN, SARA (LSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HERMAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:GOCHNAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 WILLOW PL
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2319
Mailing Address - Country:US
Mailing Address - Phone:973-769-2937
Mailing Address - Fax:
Practice Address - Street 1:21 WILLOW PL
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2319
Practice Address - Country:US
Practice Address - Phone:973-769-2937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06497100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker