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General NPI Number Information
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NPI Number | 1679297170
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Entity Type | Individual
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Provider Name | SARAH BIENVENU LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 3 CLEARVIEW CIR
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City | MOSELLE
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State | MS
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Zip | 39459-9520
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Country | US
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Telephone | 601-544-1499
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18679
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City | HATTIESBURG
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State | MS
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Zip | 39404-8679
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Country | US
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Telephone | 601-705-1901
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Fax | 601-705-1952
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C7996
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License Number State | MS
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