MEDICARE: SARAH LEANNE HAMRICK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW023804	PA

General Provider Information

NPI Number	:	1104507532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH LEANNE HAMRICK LCSW

Provider Business Mailing Address
First Line	:	PO BOX 76
Second Line	:
City	:	PINE GRV MLS
State	:	PA
Zip	:	16868-0076
Country	:	US
Telephone Number	:	336-707-9710
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 S KIRK ST
Second Line	:
City	:	PINE GROVE MILLS
State	:	PA
Zip	:	16868-1035
Country	:	US
Telephone Number	:	336-707-9710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2023
Last Update Date	:	07/27/2023

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