Provider Demographics
NPI:1881768687
Name:SMULLENS, SARAKAY (MSW)
Entity type:Individual
Prefix:MS
First Name:SARAKAY
Middle Name:
Last Name:SMULLENS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:SARAKAY
Other - Middle Name:
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1710 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-6702
Mailing Address - Country:US
Mailing Address - Phone:215-732-1539
Mailing Address - Fax:215-732-4603
Practice Address - Street 1:1710 PINE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6702
Practice Address - Country:US
Practice Address - Phone:215-732-1539
Practice Address - Fax:215-732-4603
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW000577-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical