Provider Demographics
NPI:1902655673
Name:MACKIEWICZ, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MACKIEWICZ
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 1:231 CATLIN RD
Mailing Address - Street 2:
Mailing Address - City:HARWINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06791-1714
Mailing Address - Country:US
Mailing Address - Phone:860-368-8665
Mailing Address - Fax:
Practice Address - Street 1:258 SPIELMAN HWY STE 4
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06013-1723
Practice Address - Country:US
Practice Address - Phone:860-368-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health