Provider Demographics
NPI:1841781168
Name:VELAZQUEZ, SARAH M (LICSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7712
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98417-0712
Mailing Address - Country:US
Mailing Address - Phone:253-800-9408
Mailing Address - Fax:253-301-3478
Practice Address - Street 1:PO BOX 7712
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98417-0712
Practice Address - Country:US
Practice Address - Phone:253-800-9408
Practice Address - Fax:253-301-3478
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC60860552104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker