Provider Demographics
NPI:1225537186
Name:YATSATTIE, SARA MICHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MICHELLE
Last Name:YATSATTIE
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 1:1100 MONTE LARGO DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1824
Mailing Address - Country:US
Mailing Address - Phone:505-205-3145
Mailing Address - Fax:
Practice Address - Street 1:1100 MONTE LARGO DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1824
Practice Address - Country:US
Practice Address - Phone:505-205-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NMSWB-0994-20221041C0700X
NMSWB-2024-11041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst