Provider Demographics
NPI:1821775263
Name:YELENCSICS, SARAH (MS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:YELENCSICS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 THREE ISLANDS BLVD APT 612
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2839
Mailing Address - Country:US
Mailing Address - Phone:908-510-5211
Mailing Address - Fax:
Practice Address - Street 1:3223 NW 10TH TER STE 607
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-5940
Practice Address - Country:US
Practice Address - Phone:561-990-2914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH23254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health