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General NPI Number Information
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NPI Number | 1770237463
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Entity Type | Individual
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Provider Name | SARAH CUMBERLAND
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Gender | Female
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 3290 WOODS WAY
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City | PETOSKEY
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State | MI
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Zip | 49770-8694
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Country | US
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Telephone | 231-881-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 6194 HEMLOCK ST
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City | INDIAN RIVER
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State | MI
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Zip | 49749-9723
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Country | US
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Telephone | 601-807-8131
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6451019808
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License Number State | MI
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