Healthcare Provider Details

I. General information

NPI: 1992062723
Provider Name (Legal Business Name): SARAH LYNN MCGILL MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH JOHNSON

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 07/15/2020
Certification Date: 07/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W 21ST ST STE 3L
ERIE PA
16506-6915
US

IV. Provider business mailing address

2700 W 21ST ST STE 3L
ERIE PA
16506-6915
US

V. Phone/Fax

Practice location:
  • Phone: 814-580-8882
  • Fax: 833-231-4272
Mailing address:
  • Phone: 814-490-6431
  • Fax: 833-231-4272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC006279
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006279
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: