Provider Demographics
NPI:1710796230
Name:ELAINE S. SADKOWSKI, LCSW, LLC
Entity type:Organization
Organization Name:ELAINE S. SADKOWSKI, LCSW, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SADKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-516-7396
Mailing Address - Street 1:58 WINGED ELM CT
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-3547
Mailing Address - Country:US
Mailing Address - Phone:904-470-0857
Mailing Address - Fax:
Practice Address - Street 1:58 WINGED ELM CT
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3547
Practice Address - Country:US
Practice Address - Phone:904-470-0857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-31
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization