Provider Demographics
NPI:1700575511
Name:SARABALIS, EUGENIA (LCSW)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:SARABALIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 191ST ST # 9A
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2424
Mailing Address - Country:US
Mailing Address - Phone:631-308-7715
Mailing Address - Fax:
Practice Address - Street 1:3509 191ST ST APT 9A
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:NY
Practice Address - Zip Code:11358-2424
Practice Address - Country:US
Practice Address - Phone:631-308-7715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0948461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical