Provider Demographics
NPI:1841400512
Name:SANDS, SARA BETH HENLEY (LMSW)
Entity Type:Individual
Prefix:
First Name:SARA BETH
Middle Name:HENLEY
Last Name:SANDS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 HEFNER DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-3438
Mailing Address - Country:US
Mailing Address - Phone:585-265-1432
Mailing Address - Fax:
Practice Address - Street 1:128 HEFNER DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-3438
Practice Address - Country:US
Practice Address - Phone:585-265-1432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061531104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker