Provider Demographics
NPI:1568736676
Name:MCNEIL, SARA JEAN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:JEAN
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W 45TH ST APT 7N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-3488
Mailing Address - Country:US
Mailing Address - Phone:917-257-1923
Mailing Address - Fax:
Practice Address - Street 1:530 W 45TH ST APT 7N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-3488
Practice Address - Country:US
Practice Address - Phone:917-257-1923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082136-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244257Medicaid