Provider Demographics
NPI:1831818079
Name:JANOWSKI-THERION, SARA K
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:K
Last Name:JANOWSKI-THERION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ASTER DR
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:CT
Mailing Address - Zip Code:06035-1624
Mailing Address - Country:US
Mailing Address - Phone:646-287-5551
Mailing Address - Fax:
Practice Address - Street 1:3 ASTER DR
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CT
Practice Address - Zip Code:06035-1624
Practice Address - Country:US
Practice Address - Phone:646-287-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0099971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical