Healthcare Provider Details

I. General information

NPI: 1588813091
Provider Name (Legal Business Name): SARA KATHRYN SALIB LCSW, PSY. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 W LINCOLN HWY
EXTON PA
19341-2547
US

IV. Provider business mailing address

196 BARRY AVE
LANSDALE PA
19446-6617
US

V. Phone/Fax

Practice location:
  • Phone: 717-413-7303
  • Fax:
Mailing address:
  • Phone: 717-413-7307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW123831
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS017302
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: