Provider Demographics
NPI:1699464602
Name:ZELL, SARAH KATHERINE-BRACKIN (LISW-CP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:KATHERINE-BRACKIN
Last Name:ZELL
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:K
Other - Last Name:ZELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW, INC
Mailing Address - Street 1:301 KELLWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7578
Mailing Address - Country:US
Mailing Address - Phone:803-348-8282
Mailing Address - Fax:
Practice Address - Street 1:301 KELLWOOD WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7578
Practice Address - Country:US
Practice Address - Phone:803-348-8282
Practice Address - Fax:803-381-9285
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
SC159591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker