=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710784442
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARA AHUVA SCHREIER LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2025
-----------------------------------------------------
Last Update Date | 02/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 75 MONTEBELLO RD
-----------------------------------------------------
City | MONTEBELLO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10901-3746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-523-9500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 37-14 VICTORIA RD
-----------------------------------------------------
City | FAIR LAWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07410-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-546-6119
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 095917
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------