Provider Demographics
NPI:1033837190
Name:MASALKOSKI, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MASALKOSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 DONCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-2084
Mailing Address - Country:US
Mailing Address - Phone:989-239-0870
Mailing Address - Fax:
Practice Address - Street 1:1350 HASLETT RD # 101
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2823
Practice Address - Country:US
Practice Address - Phone:989-239-0870
Practice Address - Fax:734-800-3183
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801119821104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker