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General NPI Number Information
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NPI Number | 1710796230
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Entity Type | Organization
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Legal Business Name | ELAINE S. SADKOWSKI, LCSW, LLC
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 58 WINGED ELM CT
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3547
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Country | US
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Telephone | 904-470-0857
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Fax |
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Provider Business Mailing Address
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Address Line | 58 WINGED ELM CT
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3547
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Country | US
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Telephone | 904-470-0857
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELAINE S. SADKOWSKI
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Credential | LCSW
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Telephone | 904-516-7396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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