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NPI Code Detail

MEDICARE: SARAH CLARK

MEDICARE: SARAH CLARK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerNJ
21041C0700XClinical Social Worker090226NY

General Provider Information

NPI Number : 1265931976
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH CLARK
Provider Business Mailing Address
First Line : 42 FILBERT ST
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11581-2906
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 397 BRIDGE ST FL 7
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5247
Country : US
Telephone Number : 516-768-9239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2018
Last Update Date : 01/08/2026

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Directions to “ SARAH CLARK ” Practice Location

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