Provider Demographics
NPI:1710319496
Name:RISI, SARA JOY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JOY
Last Name:RISI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:JOY
Other - Last Name:HART-RISI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3230 C. STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-565-4000
Mailing Address - Fax:907-565-4011
Practice Address - Street 1:3230 C. STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-565-4000
Practice Address - Fax:907-565-4011
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK12301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical