Healthcare Provider Details

I. General information

NPI: 1487807285
Provider Name (Legal Business Name): SARA A. B. CERAR LPC, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 04/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 E OLIN AVE STE 220
MADISON WI
53713-1482
US

IV. Provider business mailing address

122 E OLIN AVE STE 220
MADISON WI
53713-1482
US

V. Phone/Fax

Practice location:
  • Phone: 608-255-9119
  • Fax:
Mailing address:
  • Phone: 608-255-9119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15623-130
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4516-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: