MEDICARE: SARAH J HERNDON LPC-MHSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC0000002530	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134455512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH J HERNDON LPC-MHSP

Provider Business Mailing Address
First Line	:	5819 WINDING LN STE 105
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4067
Country	:	US
Telephone Number	:	423-402-0126
Fax Number	:	866-858-7831

Provider Business Practice Location Address
First Line	:	5819 WINDING LN STE 105
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4067
Country	:	US
Telephone Number	:	423-402-0126
Fax Number	:	866-858-7831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	05/22/2024

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