Provider Demographics
NPI:1811569148
Name:KOREISHI, SARAH E (LICSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:KOREISHI
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 1:5885 COLORADO AVE NW APT 405
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2961
Mailing Address - Country:US
Mailing Address - Phone:202-210-5094
Mailing Address - Fax:
Practice Address - Street 1:5885 COLORADO AVE NW APT 405
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2961
Practice Address - Country:US
Practice Address - Phone:202-210-5094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500792591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical