Provider Demographics
NPI:1063702363
Name:SERRANO, SARAH ILEM (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ILEM
Last Name:SERRANO
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 1:6731 NW 28TH TER
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1319
Mailing Address - Country:US
Mailing Address - Phone:786-200-9144
Mailing Address - Fax:
Practice Address - Street 1:6731 NW 28TH TER
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1319
Practice Address - Country:US
Practice Address - Phone:754-333-0965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2015-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW94891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical