Healthcare Provider Details

I. General information

NPI: 1184263790
Provider Name (Legal Business Name): SARAH BRONNER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH BRIDGES

II. Dates (important events)

Enumeration Date: 12/30/2019
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N MILL ST
FESTUS MO
63028-1818
US

IV. Provider business mailing address

1800 COMMUNITY
CLINTON MO
64735-8804
US

V. Phone/Fax

Practice location:
  • Phone: 844-853-8937
  • Fax:
Mailing address:
  • Phone: 660-885-8131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2024035359
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: