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General NPI Number Information
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NPI Number | 1710385968
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Entity Type | Individual
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Provider Name | SARA ELIZABETH WHITESIDE LPCC
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Gender | Female
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 5151 MONROE ST STE 250D
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City | TOLEDO
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State | OH
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Zip | 43623-3469
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Country | US
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Telephone | 419-779-4945
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Fax |
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Provider Business Mailing Address
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Address Line | 3618 WILLOW LANE DR
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City | TOLEDO
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State | OH
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Zip | 43615-1161
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Country | US
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Telephone | 419-779-4945
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.1200492
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License Number State | OH
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