Provider Demographics
NPI:1043026966
Name:CLUBB, SARAH ALICE (APSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ALICE
Last Name:CLUBB
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N SUNNY SLOPE RD STE 372
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4806
Mailing Address - Country:US
Mailing Address - Phone:414-302-1233
Mailing Address - Fax:
Practice Address - Street 1:150 N SUNNY SLOPE RD STE 372
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4806
Practice Address - Country:US
Practice Address - Phone:414-302-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI133010-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker