=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417491325
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SARAH WEBER COUNSELING SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2016
-----------------------------------------------------
Last Update Date | 12/23/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1202 N MAIN ST
-----------------------------------------------------
City | HUTCHINSON
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67501-4501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-200-1490
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1202 N MAIN ST
-----------------------------------------------------
City | HUTCHINSON
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67501-4501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-200-1490
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SARAH L WEBER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 620-200-1490
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 4299
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------