Healthcare Provider Details

I. General information

NPI: 1811785892
Provider Name (Legal Business Name): SARAH ASHLYNN LAZAR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N BROADWAY AVE
WICHITA KS
67202-2301
US

IV. Provider business mailing address

200 N BROADWAY AVE FL 5
WICHITA KS
67202-2301
US

V. Phone/Fax

Practice location:
  • Phone: 316-425-7774
  • Fax:
Mailing address:
  • Phone: 316-425-7774
  • Fax: 316-425-7779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: