Healthcare Provider Details

I. General information

NPI: 1518648070
Provider Name (Legal Business Name): SARAH YACCO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1256 CULVER AVE
UTICA NY
13501-4253
US

IV. Provider business mailing address

111 HOSPITAL DR
UTICA NY
13502-2517
US

V. Phone/Fax

Practice location:
  • Phone: 315-624-8563
  • Fax:
Mailing address:
  • Phone: 315-801-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120555
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: