MEDICARE: DR. SARAH ROSE WATERMAN LMSW

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	100469	NY
2	1041C0700X	Clinical Social Worker	6801114422	MI

General Provider Information

NPI Number	:	1437798105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH ROSE WATERMAN LMSW

Provider Business Mailing Address
First Line	:	1509 EDGEMERE DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14612-1513
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 EDGEMERE DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14612-1513
Country	:	US
Telephone Number	:	313-820-3384
Fax Number	:

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

Provider Enumeration Date	:	12/30/2019
Last Update Date	:	01/02/2026

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