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General NPI Number Information
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NPI Number | 1104249218
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Entity Type | Individual
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Provider Name | SARAH JARVIS MA
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Gender | Female
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 01/04/2018
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Provider Practice Location Address
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Address Line | 600 MONTICELLO ST STE 2
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City | SOMERSET
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State | KY
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Zip | 42501-2974
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Country | US
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Telephone | 606-401-2966
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Fax | 606-244-4111
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Provider Business Mailing Address
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Address Line | PO BOX 3932
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City | SOMERSET
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State | KY
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Zip | 42564
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 173185
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License Number State | KY
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