Provider Demographics
NPI:1447353636
Name:SADKOWSKI, ELAINE S (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:S
Last Name:SADKOWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ELAINE
Other - Middle Name:S
Other - Last Name:SADKOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:REG PLAY THERAPIST-
Mailing Address - Street 1:58 WINGED ELM CT
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-3547
Mailing Address - Country:US
Mailing Address - Phone:904-516-7396
Mailing Address - Fax:
Practice Address - Street 1:58 WINGED ELM CT
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3547
Practice Address - Country:US
Practice Address - Phone:904-470-0857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW59561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical