Provider Demographics
NPI:1609658848
Name:HALL, SARA N (LMSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:N
Last Name:HALL
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 1:8 MEADOWBROOK TER
Mailing Address - Street 2:
Mailing Address - City:CORFU
Mailing Address - State:NY
Mailing Address - Zip Code:14036-9662
Mailing Address - Country:US
Mailing Address - Phone:716-495-1269
Mailing Address - Fax:
Practice Address - Street 1:8 MEADOWBROOK TER
Practice Address - Street 2:
Practice Address - City:CORFU
Practice Address - State:NY
Practice Address - Zip Code:14036-9662
Practice Address - Country:US
Practice Address - Phone:716-495-1269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109466104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker