Provider Demographics
NPI:1154163194
Name:WOOLARD-RACZKA, SARAH (LCSW, LADC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WOOLARD-RACZKA
Suffix:
Gender:F
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 CHAMBERLAIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-5546
Mailing Address - Country:US
Mailing Address - Phone:860-262-8681
Mailing Address - Fax:
Practice Address - Street 1:100 RIVERVIEW CTR STE 312
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3447
Practice Address - Country:US
Practice Address - Phone:860-262-8681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000975101YA0400X
CT0085291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)