Healthcare Provider Details

I. General information

NPI: 1013891761
Provider Name (Legal Business Name): SARA BAYLEE GEIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 WILLIAMSBURG ST BLDG B
LAKE CHARLES LA
70605-5720
US

IV. Provider business mailing address

184 WILLIAMSBURG ST BLDG B
LAKE CHARLES LA
70605-5720
US

V. Phone/Fax

Practice location:
  • Phone: 337-437-4014
  • Fax:
Mailing address:
  • Phone: 337-437-4014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number349216
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number349216
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: