Healthcare Provider Details

I. General information

NPI: 1922789718
Provider Name (Legal Business Name): SARAH GRABER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3118 S LAFOUNTAIN ST
KOKOMO IN
46902-3710
US

IV. Provider business mailing address

8003 CASTLEWAY DR
INDIANAPOLIS IN
46250-1946
US

V. Phone/Fax

Practice location:
  • Phone: 765-864-4160
  • Fax: 765-400-4467
Mailing address:
  • Phone: 317-576-1335
  • Fax: 317-343-6562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39004611A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: