Provider Demographics
NPI:1689064461
Name:DR. SARAH BROTSKY & ASSOCIATES, PLC
Entity Type:Organization
Organization Name:DR. SARAH BROTSKY & ASSOCIATES, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BROTSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:248-686-0355
Mailing Address - Street 1:74 W LONG LAKE RD
Mailing Address - Street 2:100
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-2769
Mailing Address - Country:US
Mailing Address - Phone:248-686-0355
Mailing Address - Fax:
Practice Address - Street 1:74 W LONG LAKE RD
Practice Address - Street 2:100
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-2769
Practice Address - Country:US
Practice Address - Phone:248-686-0355
Practice Address - Fax:248-686-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013021103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty