Provider Demographics
NPI:1649667163
Name:WILKINSON, SARAH MACKENZIE (LCSW-R)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MACKENZIE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 MADISON AVE
Mailing Address - Street 2:INSTITUTE FOR FAMILY HEALTH
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8022
Mailing Address - Country:US
Mailing Address - Phone:917-658-0386
Mailing Address - Fax:
Practice Address - Street 1:274 MADISON AVE
Practice Address - Street 2:INSTITUTE FOR FAMILY HEALTH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0701
Practice Address - Country:US
Practice Address - Phone:917-658-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR071636-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical