Healthcare Provider Details
I. General information
NPI: 1184653586
Provider Name (Legal Business Name): SARAH JEAN HERRING LGSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 VETERANS AVE
BILOXI MS
39531-2410
US
IV. Provider business mailing address
4616 LEWIS ST
GULFPORT MS
39501-1204
US
V. Phone/Fax
- Phone: 228-523-5000
- Fax: 228-523-5336
- Phone: 228-229-3342
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 2090G |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | M5608 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: