Provider Demographics
NPI:1043049554
Name:SARAH BORO LICENSED CLINICAL SOCIAL WORKER, PC
Entity type:Organization
Organization Name:SARAH BORO LICENSED CLINICAL SOCIAL WORKER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BORO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:650-339-9104
Mailing Address - Street 1:2020 MEZES AVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-1745
Mailing Address - Country:US
Mailing Address - Phone:650-339-9104
Mailing Address - Fax:
Practice Address - Street 1:2020 MEZES AVE
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-1745
Practice Address - Country:US
Practice Address - Phone:650-339-9104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty