Healthcare Provider Details

I. General information

NPI: 1275178931
Provider Name (Legal Business Name): SARAH ROFFE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2019
Last Update Date: 11/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 BERKELEY PL
BROOKLYN NY
11217-4492
US

IV. Provider business mailing address

28 BERKELEY PL APT 3
BROOKLYN NY
11217-4453
US

V. Phone/Fax

Practice location:
  • Phone: 917-991-3191
  • Fax:
Mailing address:
  • Phone: 917-991-3191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number88714
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: