Provider Demographics
NPI:1851925028
Name:MILANOWSKI, SARAH LEE (LMSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LEE
Last Name:MILANOWSKI
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 1:3112 HIGHGATE AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-2980
Mailing Address - Country:US
Mailing Address - Phone:616-304-8536
Mailing Address - Fax:
Practice Address - Street 1:3112 HIGHGATE AVE SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-2980
Practice Address - Country:US
Practice Address - Phone:616-304-8536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010939551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical