Healthcare Provider Details

I. General information

NPI: 1780339168
Provider Name (Legal Business Name): BLAIR SARAH GRANT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SE FEDERAL HWY STE 334
STUART FL
34994-3839
US

IV. Provider business mailing address

2951 SE HAWTHORNE ST
STUART FL
34997-5230
US

V. Phone/Fax

Practice location:
  • Phone: 239-690-6906
  • Fax:
Mailing address:
  • Phone: 561-676-0686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW24638
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: