Healthcare Provider Details

I. General information

NPI: 1316598519
Provider Name (Legal Business Name): SARAH ALICIA ARMSTRONG LCSW - 38396
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2019
Last Update Date: 09/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6351 N COLFAX ST
DALTON GARDENS ID
83815-9284
US

IV. Provider business mailing address

PO BOX 509
HAYDEN ID
83835-0509
US

V. Phone/Fax

Practice location:
  • Phone: 208-699-6458
  • Fax:
Mailing address:
  • Phone: 208-699-6458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number38396
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: