Provider Demographics
NPI:1710862826
Name:TILLOTSON, SARIAH ROSE (MSW)
Entity type:Individual
Prefix:
First Name:SARIAH
Middle Name:ROSE
Last Name:TILLOTSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SARIAH
Other - Middle Name:ROSE
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:9 W 103RD ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4613
Mailing Address - Country:US
Mailing Address - Phone:916-893-3966
Mailing Address - Fax:
Practice Address - Street 1:9 W 103RD ST APT 1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4613
Practice Address - Country:US
Practice Address - Phone:916-893-3966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical