Provider Demographics
NPI:1659848638
Name:HAINES, SARAH MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:HAINES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:MICHALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 CHESTNUT ST STE 224
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3295
Mailing Address - Country:US
Mailing Address - Phone:814-636-0313
Mailing Address - Fax:
Practice Address - Street 1:310 CHESTNUT ST STE 224
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3295
Practice Address - Country:US
Practice Address - Phone:814-636-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0216091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical