Healthcare Provider Details

I. General information

NPI: 1831760537
Provider Name (Legal Business Name): SARAH HAFNER LPC-MHSP (TEMP)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2021
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 POPLAR AVE STE 224
MEMPHIS TN
38117-7506
US

IV. Provider business mailing address

4515 POPLAR AVE STE 224
MEMPHIS TN
38117-7506
US

V. Phone/Fax

Practice location:
  • Phone: 901-654-5551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6397
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: