Provider Demographics
NPI:1962877548
Name:YAGOVANE, SARAH (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:YAGOVANE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SALATTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:949 BRIDGEPORT AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460
Mailing Address - Country:US
Mailing Address - Phone:203-878-6365
Mailing Address - Fax:
Practice Address - Street 1:609 ROUTE 80
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-1219
Practice Address - Country:US
Practice Address - Phone:203-675-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT104100000X
CT0121341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker