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1841173523 NPI number — SARAH R WILSON PHD, MA, APC

NPI Number: 1841173523
Health Care Provider/Practitioner: SARAH R WILSON PHD, MA, APC

Information about “1841173523” NPI (SARAH R WILSON PHD, MA, APC) exists in 1841173523 in HTML format HTML  |  1841173523 in plain Text format TXT  |  1841173523 in PDF (Portable Document Format) PDF  |  1841173523 in an XML format XML  formats.

NPI Number : 1841173523 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1841173523",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WILSON",
    "FirstName": "SARAH",
    "MiddleName": "R",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHD, MA, APC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WILSON-MONTEMAYOR",
    "OtherFirstName": "SARAH",
    "OtherMiddleName": "R",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "PHD, MA, APC",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "SOUL WEAVING COUNSELING, LLC",
    "SecondLineMailingAddress": "5331 S MACADAM AVE, SUITE 258; PMB 420",
    "MailingAddressCityName": "PORTLAND",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97239",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-573-5681",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5441 S MACADAM AVE STE R",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORTLAND",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97239-3822",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "503-573-5681",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/29/2025",
    "LastUpdateDate": "07/29/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "R11134",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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