Provider Demographics
NPI:1528314184
Name:CAMILLERI, SARA RENEE ERICKSON (LMSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:RENEE ERICKSON
Last Name:CAMILLERI
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 1:4007 CARPENTER RD STE 118
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9644
Mailing Address - Country:US
Mailing Address - Phone:734-707-1020
Mailing Address - Fax:
Practice Address - Street 1:4007 CARPENTER RD STE 118
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9644
Practice Address - Country:US
Practice Address - Phone:734-707-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801094619104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker