Provider Demographics
NPI:1750815791
Name:HAYDOCK, SARAH (LCSW, RPT, PPSC)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:HAYDOCK
Suffix:
Gender:F
Credentials:LCSW, RPT, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 ENCINITAS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-8704
Mailing Address - Country:US
Mailing Address - Phone:858-434-8871
Mailing Address - Fax:
Practice Address - Street 1:328 ENCINITAS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-8704
Practice Address - Country:US
Practice Address - Phone:858-434-8871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1131701041C0700X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty