MEDICARE: MS. SARA MARIE DEESE MCAP,LMHC, LPC, LPCC

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	6779	TN
2	101YM0800X	Mental Health Counselor	19441	NC
3	101YM0800X	Mental Health Counselor	0701012926	VA
4	101YM0800X	Mental Health Counselor	13595772-6004	UT
5	101YM0800X	Mental Health Counselor	46.006796	CT
6	101YM0800X	Mental Health Counselor	01595	RI
7	101YM0800X	Mental Health Counselor	9119	SC
8	101YM0800X	Mental Health Counselor	4007	MN
9	101YM0800X	Mental Health Counselor	2023032955	MO
10	101YP2500X	Professional Counselor	10495-125	WI
11	101YM0800X	Mental Health Counselor	MH18260	FL
12	101Y00000X	Counselor	LPC-22739	AZ

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	:	1376152702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARA MARIE DEESE MCAP,LMHC, LPC, LPCC

Provider Business Mailing Address
First Line	:	7316 OTTER CREEK DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-4000
Country	:	US
Telephone Number	:	727-410-9281
Fax Number	:

Provider Business Practice Location Address
First Line	:	5411 GRAND BLVD STE 109
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4010
Country	:	US
Telephone Number	:	727-304-3842
Fax Number	:	727-291-7623

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

Provider Enumeration Date	:	07/31/2020
Last Update Date	:	05/02/2024

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