Healthcare Provider Details

I. General information

NPI: 1588218671
Provider Name (Legal Business Name): SARA PAIGE SARGINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2019
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CROWN OAK CENTRE DR
LONGWOOD FL
32750-6149
US

IV. Provider business mailing address

380 CROWN OAK CENTRE DR
LONGWOOD FL
32750-6149
US

V. Phone/Fax

Practice location:
  • Phone: 407-494-4451
  • Fax:
Mailing address:
  • Phone: 813-422-8772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH23628
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: