Provider Demographics
NPI:1902809668
Name:BERGER, SARA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 HENRY HUDSON PARKWAY
Mailing Address - Street 2:APT 810
Mailing Address - City:RIVERDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3811
Mailing Address - Country:US
Mailing Address - Phone:718-549-2605
Mailing Address - Fax:718-884-1338
Practice Address - Street 1:4525 HENRY HUDSON PARKWAY
Practice Address - Street 2:APT 810
Practice Address - City:RIVERDALE
Practice Address - State:NY
Practice Address - Zip Code:10471-3811
Practice Address - Country:US
Practice Address - Phone:718-549-2605
Practice Address - Fax:718-884-1338
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021607-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY021607-1OtherNYS LICENSE