Healthcare Provider Details

I. General information

NPI: 1962191148
Provider Name (Legal Business Name): SARAH C TREASTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 WATERMAN ST
PROVIDENCE RI
02906-3919
US

IV. Provider business mailing address

108 RICE ST
PAWTUCKET RI
02861-1579
US

V. Phone/Fax

Practice location:
  • Phone: 267-324-9564
  • Fax:
Mailing address:
  • Phone: 505-660-2639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW04832
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW027383
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SC05987000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: