Healthcare Provider Details

I. General information

NPI: 1386410793
Provider Name (Legal Business Name): SARAH N BUCK-MORRILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 STATE HIGHWAY 310
CANTON NY
13617-1459
US

IV. Provider business mailing address

221 HAMILTON ST
OGDENSBURG NY
13669-1707
US

V. Phone/Fax

Practice location:
  • Phone: 315-393-0264
  • Fax: 315-386-0265
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number122057
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number230643
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: