MEDICARE: SARAH L SUTTON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	19234	TX

General Provider Information

NPI Number	:	1144422981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH L SUTTON LCSW

Provider Business Mailing Address
First Line	:	905 CASTLE RIDGE RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-5107
Country	:	US
Telephone Number	:	512-502-9585
Fax Number	:

Provider Business Practice Location Address
First Line	:	5524 BEE CAVE ROAD
Second Line	:	K-2B
City	:	AUSTIN
State	:	TX
Zip	:	78746-7874
Country	:	US
Telephone Number	:	512-502-9585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	07/08/2007

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