MEDICARE: SARA E CREEL

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	MH17610	FL

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	:	1932645652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA E CREEL

Provider Business Mailing Address
First Line	:	4300 SW 13TH ST
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-4006
Country	:	US
Telephone Number	:	321-397-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 NE 238TH STREET
Second Line	:
City	:	CROSS CITY
State	:	FL
Zip	:	32693-5719
Country	:	US
Telephone Number	:	352-471-0069
Fax Number	:	352-244-0304

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

Provider Enumeration Date	:	01/19/2017
Last Update Date	:	01/29/2020

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Directions to “ SARA E CREEL ” Practice Location

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