Provider Demographics
NPI:1790541944
Name:HERBST, SARA (LSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HERBST
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:SCHAPIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:76 CHERRY ST.
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:917-789-3124
Mailing Address - Fax:
Practice Address - Street 1:908 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5997
Practice Address - Country:US
Practice Address - Phone:732-761-7363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06811000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker