Healthcare Provider Details

I. General information

NPI: 1487249959
Provider Name (Legal Business Name): SARAH COAN ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH COAN LEONI RBT

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 05/02/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 S MAIN ST STE A4
CEDAR CITY UT
84720-3432
US

IV. Provider business mailing address

444 S MAIN ST
CEDAR CITY UT
84720-3468
US

V. Phone/Fax

Practice location:
  • Phone: 435-572-0510
  • Fax:
Mailing address:
  • Phone: 435-572-0510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: