Provider Demographics
NPI:1760946933
Name:GORCOS, SARA (LICSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:GORCOS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35302 SE CENTER ST # 514
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9216
Mailing Address - Country:US
Mailing Address - Phone:425-276-1885
Mailing Address - Fax:206-934-4831
Practice Address - Street 1:35302 SE CENTER ST # 514
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9216
Practice Address - Country:US
Practice Address - Phone:425-276-1885
Practice Address - Fax:206-934-4831
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW613441941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2120969Medicaid