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NPI Code Detail

MEDICARE: SARAH EMELIA MAWDSLEY LPC

MEDICARE: SARAH EMELIA MAWDSLEY 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578139309
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH EMELIA MAWDSLEY LPC
Provider Business Mailing Address
First Line : 18450 SW LAPAZ CT
Second Line :
City : BEAVERTON
State : OR
Zip : 97007-5271
Country : US
Telephone Number : 512-413-2802
Fax Number :
Provider Business Practice Location Address
First Line : 1909 MOUNTAIN VIEW LN STE 202
Second Line :
City : FOREST GROVE
State : OR
Zip : 97116-2893
Country : US
Telephone Number : 999-999-9999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2021
Last Update Date : 06/26/2024

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