Provider Demographics
NPI:1982230330
Name:CARPENTER, SARA (LMSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:CARPENTER
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 1:462 COVEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1108
Mailing Address - Country:US
Mailing Address - Phone:716-512-9437
Mailing Address - Fax:
Practice Address - Street 1:462 COVEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1108
Practice Address - Country:US
Practice Address - Phone:716-512-9437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103556104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker