MEDICARE: SARAH ELIZABETH MCPHILLIPS LPC

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	101YP2500X	Professional Counselor	LPC-19026	AZ

General Provider Information

NPI Number	:	1184204604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ELIZABETH MCPHILLIPS LPC

Provider Business Mailing Address
First Line	:	2215 HUALAPAI MOUNTAIN RD STE F-I
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86401-8324
Country	:	US
Telephone Number	:	928-753-9387
Fax Number	:	928-753-9404

Provider Business Practice Location Address
First Line	:	2215 HUALAPAI MOUNTAIN RD STE F-I
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86401-8324
Country	:	US
Telephone Number	:	928-753-9387
Fax Number	:	928-753-9404

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

Provider Enumeration Date	:	04/09/2021
Last Update Date	:	04/09/2021

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