Healthcare Provider Details

I. General information

NPI: 1144138918
Provider Name (Legal Business Name): SARAH ELIZABETH VISLEY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 W RUDISILL BLVD STE 222
FORT WAYNE IN
46807-2160
US

IV. Provider business mailing address

1027 W RUDISILL BLVD
FORT WAYNE IN
46807-2160
US

V. Phone/Fax

Practice location:
  • Phone: 260-402-4264
  • Fax: 260-977-2084
Mailing address:
  • Phone: 260-402-4264
  • Fax: 260-977-2084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39006183A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: