Provider Demographics
NPI:1720605934
Name:MICIELI, SARA ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:MICIELI
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 1:103 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2345
Mailing Address - Country:US
Mailing Address - Phone:516-732-1415
Mailing Address - Fax:
Practice Address - Street 1:1399 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-7400
Practice Address - Country:US
Practice Address - Phone:516-969-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-03
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0984371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical