Healthcare Provider Details

I. General information

NPI: 1437458460
Provider Name (Legal Business Name): SARA LYNN WILSON PSY.D, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA LYNN JAMES

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E BRADFORD PKWY
SPRINGFIELD MO
65804-4264
US

IV. Provider business mailing address

1300 E BRADFORD PKWY
SPRINGFIELD MO
65804-4264
US

V. Phone/Fax

Practice location:
  • Phone: 417-761-5000
  • Fax: 417-761-5065
Mailing address:
  • Phone: 417-761-5000
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2012033737
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number2012033737
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: