=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245847813
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH HUNT MSW, LLMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2020
-----------------------------------------------------
Last Update Date | 09/28/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1061 S GETTY ST
-----------------------------------------------------
City | MUSKEGON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49442-4066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-722-7980
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9293 W 32ND ST
-----------------------------------------------------
City | FREMONT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49412-8004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-750-3788
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 6801107742
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------