Sarah A Black | Salt Lake City, UT • PECOS Search

Sarah A Black

Social Worker

Behavioral Health & Social Service Providers

5965 S 900 E, Salt Lake City, UT 84121-1720

(801) 263-7100 (801) 602-9903

PECOS Enrollment

Based on the most recent information from CMS, provider Sarah A Black does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1912331679
Provider Type
Individual
Full Name
Black, Sarah A
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
8/29/2013
Last Updated
9/21/2019

Contact Information

Practice Location

5965 S 900 E, Salt Lake City, UT 84121-1720

Unlisted Fax

Mailing Location

576 N 400 W, Salt Lake City, UT 84103-1310

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 9432853-3501 Utah