Healthcare Provider Details

I. General information

NPI: 1528623782
Provider Name (Legal Business Name): SARA HUTCHINSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 NELSON RD
LUDINGTON MI
49431-1939
US

IV. Provider business mailing address

121 NELSON RD
LUDINGTON MI
49431-1939
US

V. Phone/Fax

Practice location:
  • Phone: 231-690-9637
  • Fax: 231-845-7095
Mailing address:
  • Phone: 231-690-9637
  • Fax: 231-845-7095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401017190
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: