Provider Demographics
NPI:1578780680
Name:WILMOT, SARAH GREEN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:GREEN
Last Name:WILMOT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JOYCE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:151 MERRIMAC ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-4714
Mailing Address - Country:US
Mailing Address - Phone:617-643-4699
Mailing Address - Fax:
Practice Address - Street 1:151 MERRIMAC ST FL 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4714
Practice Address - Country:US
Practice Address - Phone:617-643-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2139151041C0700X
MA1150381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical