Provider Demographics
NPI:1972196129
Name:BERGER, SARAH (LMSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BEHAVIOR ANALYST
Mailing Address - Street 1:1312 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3612
Mailing Address - Country:US
Mailing Address - Phone:718-686-3700
Mailing Address - Fax:
Practice Address - Street 1:1312 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3612
Practice Address - Country:US
Practice Address - Phone:718-686-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NY003622-01103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist