Provider Demographics
NPI:1619744828
Name:WARDICK, SARAH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:WARDICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-5118
Mailing Address - Country:US
Mailing Address - Phone:386-222-9994
Mailing Address - Fax:
Practice Address - Street 1:150 ROUSE BLVD # 210
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19112-1901
Practice Address - Country:US
Practice Address - Phone:800-841-8730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW191791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical