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NPI Code Detail

MEDICARE: SARA PREWITT LPC

MEDICARE: SARA PREWITT 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
1101YP2500XProfessional Counselor5760LA

General Provider Information

NPI Number : 1235509365
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA PREWITT LPC
Provider Business Mailing Address
First Line : 4951 CENTRAL AVE
Second Line :
City : MONROE
State : LA
Zip : 71203-6156
Country : US
Telephone Number : 318-340-1535
Fax Number :
Provider Business Practice Location Address
First Line : 4951 CENTRAL AVE
Second Line :
City : MONROE
State : LA
Zip : 71203-6156
Country : US
Telephone Number : 318-340-1535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2015
Last Update Date : 10/01/2015

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Directions to “ SARA PREWITT LPC” Practice Location

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