Healthcare Provider Details

I. General information

NPI: 1780415976
Provider Name (Legal Business Name): SARAH NOTEBAERT LCSW, CAADC, CCTP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 10/22/2026
Certification Date: 10/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 LANCASTER AVE STE 210
WAYNE PA
19087-2558
US

IV. Provider business mailing address

200 WYLLPEN DR
WEST CHESTER PA
19380-6642
US

V. Phone/Fax

Practice location:
  • Phone: 484-222-8657
  • Fax:
Mailing address:
  • Phone: 484-222-8657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW024372
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: