MEDICARE: SARAH WEST, LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1841041969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH WEST, LLC

Provider Business Mailing Address
First Line	:	7211 E 112TH PL S
Second Line	:
City	:	BIXBY
State	:	OK
Zip	:	74008-2153
Country	:	US
Telephone Number	:	918-607-7031
Fax Number	:

Provider Business Practice Location Address
First Line	:	6846 S CANTON AVE STE 520L
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-3417
Country	:	US
Telephone Number	:	918-922-8127
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. SARAH WEST
Credential	:	LCSW
Telephone Number	:	918-607-7031

Provider Enumeration Date	:	03/27/2024
Last Update Date	:	03/27/2024

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