Healthcare Provider Details

I. General information

NPI: 1760623078
Provider Name (Legal Business Name): SARAH M STANTON M.ED, LMHC, CDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 03/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 E 72ND ST
TACOMA WA
98404-5406
US

IV. Provider business mailing address

1919 7TH ST SW
PUYALLUP WA
98371-7423
US

V. Phone/Fax

Practice location:
  • Phone: 253-222-8486
  • Fax: 253-864-4997
Mailing address:
  • Phone: 253-222-8486
  • Fax: 253-864-4997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP60117058
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60016068
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: