Healthcare Provider Details

I. General information

NPI: 1528305000
Provider Name (Legal Business Name): SARAH KATHRYN DUBISAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 WASHBURN WAY UNIT 210
KLAMATH FALLS OR
97603-4593
US

IV. Provider business mailing address

2650 WASHBURN WAY UNIT 210
KLAMATH FALLS OR
97603-4593
US

V. Phone/Fax

Practice location:
  • Phone: 541-892-6673
  • Fax: 541-882-7111
Mailing address:
  • Phone: 541-892-6673
  • Fax: 541-882-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL4905
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: