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NPI Code Detail

MEDICARE: SARAH ADDISON, LLC

MEDICARE: SARAH ADDISON, LLC
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 CounselorLPC004890GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730327495
Entity Type Code : Organization
Provider Name (Legal Business Name) : SARAH ADDISON, LLC
Provider Business Mailing Address
First Line : 138 JASON POND WAY
Second Line :
City : JEFFERSON
State : GA
Zip : 30549-7247
Country : US
Telephone Number : 678-231-5557
Fax Number : 706-850-0899
Provider Business Practice Location Address
First Line : 5415 THOMPSON MILL RD
Second Line :
City : HOSCHTON
State : GA
Zip : 30548-4132
Country : US
Telephone Number : 678-231-5557
Fax Number : 706-850-0899
Authorized Official
Title or Position : OWNER
Name : SARAH ADDISON
Credential : LPC
Telephone Number : 678-231-5557
Provider Enumeration Date : 02/03/2009
Last Update Date : 02/03/2009

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