MEDICARE: SARRAH GARVIN PCC

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	103116	KY
2	101YP2500X	Professional Counselor	C.0500396	OH

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	:	1568771285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARRAH GARVIN PCC

Provider Business Mailing Address
First Line	:	1717 DIXIE HWY STE 415
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-2766
Country	:	US
Telephone Number	:	859-391-2681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 DIXIE HWY STE 415
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-2766
Country	:	US
Telephone Number	:	859-391-2681
Fax Number	:

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

Provider Enumeration Date	:	09/29/2010
Last Update Date	:	01/25/2021

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