Provider Demographics
NPI:1790107613
Name:ANDREW-MADISON, SARAH (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ANDREW-MADISON
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 1:511 W 232ND ST APT W44
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3533
Mailing Address - Country:US
Mailing Address - Phone:646-859-2028
Mailing Address - Fax:
Practice Address - Street 1:3725 HENRY HUDSON PKWY STE 1D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1527
Practice Address - Country:US
Practice Address - Phone:646-859-2028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-12
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085630-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical