Provider Demographics
NPI:1457114449
Name:KEATON, SARAH BOWIE (LMSW)
Entity type:Individual
Prefix:
First Name:SARAH BOWIE
Middle Name:
Last Name:KEATON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 HUNTINGTON HLS S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14622-1134
Mailing Address - Country:US
Mailing Address - Phone:585-730-0764
Mailing Address - Fax:
Practice Address - Street 1:441 EAST AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1932
Practice Address - Country:US
Practice Address - Phone:585-386-3743
Practice Address - Fax:585-386-3792
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122263101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health