Provider Demographics
NPI:1578192696
Name:SARA GASPER PSYCHOTHERAPY
Entity type:Organization
Organization Name:SARA GASPER PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINCIAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-910-0479
Mailing Address - Street 1:2815 S LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-8861
Mailing Address - Country:US
Mailing Address - Phone:308-398-0350
Mailing Address - Fax:308-398-0351
Practice Address - Street 1:2815 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-8861
Practice Address - Country:US
Practice Address - Phone:308-398-0350
Practice Address - Fax:308-398-0351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty