Provider Demographics
NPI:1972736544
Name:SOURI, SARAH (MSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:SOURI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 VALLEY BROOKE CT
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7827
Mailing Address - Country:US
Mailing Address - Phone:412-400-4315
Mailing Address - Fax:
Practice Address - Street 1:9500 BROOKTREE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9227
Practice Address - Country:US
Practice Address - Phone:412-400-4315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0163471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical