Provider Demographics
NPI:1770175341
Name:BRAUN, SARA GRAY (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:GRAY
Last Name:BRAUN
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 1:7A RIDGELAND MNR
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3641
Mailing Address - Country:US
Mailing Address - Phone:914-309-6729
Mailing Address - Fax:
Practice Address - Street 1:35 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3004
Practice Address - Country:US
Practice Address - Phone:914-309-6729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0750441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty