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General NPI Number Information
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NPI Number | 1295039428
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Entity Type | Individual
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Provider Name | SARAH DENISE VINSON LCSW, SAC
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Gender | Female
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 2960 TRIVERTON PIKE DR SUITE 102
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City | FITCHBURG
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State | WI
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Zip | 53711-7514
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Country | US
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Telephone | 608-400-3818
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Fax | 608-709-8066
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Provider Business Mailing Address
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Address Line | 2960 TRIVERTON PIKE DR SUITE 102
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City | FITCHBURG
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State | WI
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Zip | 53711-7514
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Country | US
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Telephone | 608-400-1708
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Fax | 608-709-8066
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15457-130
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 127936-121
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License Number State | WI
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