Provider Demographics
NPI:1396491189
Name:SARA CAMILLERI LMSW LLC
Entity type:Organization
Organization Name:SARA CAMILLERI LMSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMILLERI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-626-8484
Mailing Address - Street 1:4007 CARPENTER RD STE 118
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9644
Mailing Address - Country:US
Mailing Address - Phone:734-626-8484
Mailing Address - Fax:
Practice Address - Street 1:4602 MERRITT RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9319
Practice Address - Country:US
Practice Address - Phone:734-626-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health