MEDICARE: SARAH KINGSLEY

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	MI0782	NV

General Provider Information

NPI Number	:	1295034965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH KINGSLEY

Provider Business Mailing Address
First Line	:	2321 CASERTA CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-5318
Country	:	US
Telephone Number	:	702-378-2543
Fax Number	:

Provider Business Practice Location Address
First Line	:	2321 CASERTA CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-5318
Country	:	US
Telephone Number	:	702-378-2543
Fax Number	:

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

Provider Enumeration Date	:	03/21/2011
Last Update Date	:	10/24/2019

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