Provider Demographics
NPI:1982981874
Name:KIM, SARAH (LSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 KANTNER LN S
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-9548
Mailing Address - Country:US
Mailing Address - Phone:484-678-3725
Mailing Address - Fax:
Practice Address - Street 1:1110 SNYDER RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609-1151
Practice Address - Country:US
Practice Address - Phone:610-678-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW127169104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker