Healthcare Provider Details

I. General information

NPI: 1245093046
Provider Name (Legal Business Name): SARAH R BELCHER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 MURRAY GUARD DR
JACKSON TN
38305-3610
US

IV. Provider business mailing address

31 BUCKTHORN CV
JACKSON TN
38305-6653
US

V. Phone/Fax

Practice location:
  • Phone: 731-435-3408
  • Fax:
Mailing address:
  • Phone: 731-616-3872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8976
License Number StateTN

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: