Provider Demographics
NPI:1538452651
Name:VALK, SARAH (LCSW-R)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:VALK
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ROUSES POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12979-1401
Mailing Address - Country:US
Mailing Address - Phone:518-569-6309
Mailing Address - Fax:518-298-0088
Practice Address - Street 1:100 WALNUT ST
Practice Address - Street 2:SUITE 006
Practice Address - City:CHAMPLAIN
Practice Address - State:NY
Practice Address - Zip Code:12919-5335
Practice Address - Country:US
Practice Address - Phone:518-569-6309
Practice Address - Fax:518-298-0088
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2015-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071368-1R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical