Healthcare Provider Details

I. General information

NPI: 1285261305
Provider Name (Legal Business Name): SARAH R WALDRON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 FRANKLIN ST
SCHENECTADY NY
12305-2008
US

IV. Provider business mailing address

538 PARK AVE
ALBANY NY
12208-3208
US

V. Phone/Fax

Practice location:
  • Phone: 518-381-8911
  • Fax:
Mailing address:
  • Phone: 845-625-8864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: