Provider Demographics
NPI:1265590038
Name:NEWMAN, SARA JANE (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JANE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8018 W CAPITOL DR
Mailing Address - Street 2:UNIT 6
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1906
Mailing Address - Country:US
Mailing Address - Phone:414-559-8864
Mailing Address - Fax:
Practice Address - Street 1:8018 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1906
Practice Address - Country:US
Practice Address - Phone:414-559-8864
Practice Address - Fax:414-433-1919
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8016-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43567800Medicaid
WI000584071Medicare ID - Type Unspecified