Provider Demographics
NPI:1972190742
Name:MCDONALD, SARAH ELAINE (LICSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELAINE
Last Name:MCDONALD
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 1:33 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2931
Mailing Address - Country:US
Mailing Address - Phone:614-216-1363
Mailing Address - Fax:
Practice Address - Street 1:33 PIERCE ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-2931
Practice Address - Country:US
Practice Address - Phone:614-216-1363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1215091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical