Healthcare Provider Details

I. General information

NPI: 1699455758
Provider Name (Legal Business Name): SARAH MCCUTCHEON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

S7390 S DAVIS DR
EAU CLAIRE WI
54701-7852
US

IV. Provider business mailing address

S7390 S DAVIS DR
EAU CLAIRE WI
54701-7852
US

V. Phone/Fax

Practice location:
  • Phone: 715-492-1229
  • Fax:
Mailing address:
  • Phone: 715-492-1229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8392226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: