Provider Demographics
NPI:1215151691
Name:STARBIRD, SARAH E (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:STARBIRD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:BOURASSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:34 LYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-2808
Mailing Address - Country:US
Mailing Address - Phone:203-445-6445
Mailing Address - Fax:
Practice Address - Street 1:1078 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2651
Practice Address - Country:US
Practice Address - Phone:203-445-6445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0063831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical