Provider Demographics
NPI:1720606817
Name:LUEM, SARAH (PSYD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LUEM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 BROADWAY, 3RD FLOOR
Mailing Address - Street 2:#4228
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:929-586-9081
Mailing Address - Fax:
Practice Address - Street 1:1178 BROADWAY, 3RD FLOOR
Practice Address - Street 2:#4228
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:929-586-9081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100649500103TC0700X
NYP103654103TC0700X
NMPSY1658103TC0700X
NY023945103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical