Healthcare Provider Details

I. General information

NPI: 1659266740
Provider Name (Legal Business Name): SARAH SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 BLUEBONNET BLVD APT 608S
BATON ROUGE LA
70810-1682
US

IV. Provider business mailing address

7410 BLUEBONNET BLVD APT 608S
BATON ROUGE LA
70810-1682
US

V. Phone/Fax

Practice location:
  • Phone: 316-806-3046
  • Fax:
Mailing address:
  • Phone: 316-806-3046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC11160
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: