Provider Demographics
NPI:1881099273
Name:KROESSER, SARAH (LICSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KROESSER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:KROESSER
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:115 MILL ST
Mailing Address - Street 2:ACADEMIC CENTER, 209
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1064
Mailing Address - Country:US
Mailing Address - Phone:617-855-2953
Mailing Address - Fax:617-855-2802
Practice Address - Street 1:115 MILL ST
Practice Address - Street 2:ACADEMIC CENTER, 209
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1064
Practice Address - Country:US
Practice Address - Phone:617-855-2953
Practice Address - Fax:617-855-2802
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1185111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical