Healthcare Provider Details

I. General information

NPI: 1992829188
Provider Name (Legal Business Name): SARAH MARSDEN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 N MAIN ST
ROCHELLE IL
61068-1686
US

IV. Provider business mailing address

1050 N 8TH ST
ROCHELLE IL
61068-1412
US

V. Phone/Fax

Practice location:
  • Phone: 815-501-2088
  • Fax:
Mailing address:
  • Phone: 815-520-0384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180007387
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: