Provider Demographics
NPI:1427437490
Name:BEREN, SARAH (LCAT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BEREN
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 METRO PARK
Mailing Address - Street 2:
Mailing Address - City:ROCHESTERS
Mailing Address - State:NY
Mailing Address - Zip Code:14623
Mailing Address - Country:US
Mailing Address - Phone:585-430-9877
Mailing Address - Fax:585-486-5772
Practice Address - Street 1:115 METRO PARK
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623
Practice Address - Country:US
Practice Address - Phone:585-430-9877
Practice Address - Fax:585-486-5772
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001874101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty