Provider Demographics
NPI:1053184069
Name:ADEYINKA-SKOLD, SARAH (LCSW)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:ADEYINKA-SKOLD
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 1:3935 W 58TH PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2913
Mailing Address - Country:US
Mailing Address - Phone:562-900-9140
Mailing Address - Fax:
Practice Address - Street 1:3935 W 58TH PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2913
Practice Address - Country:US
Practice Address - Phone:562-900-9140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSW13470104100000X
PACW018178104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker