Provider Demographics
NPI:1871068767
Name:DESJARDINS, SARAH (LMHCA, MA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DESJARDINS
Suffix:
Gender:F
Credentials:LMHCA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 HOFFMAN RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:AK
Mailing Address - Zip Code:99559-0265
Mailing Address - Country:US
Mailing Address - Phone:907-676-1201
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 287
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:AK
Practice Address - Zip Code:99559-0287
Practice Address - Country:US
Practice Address - Phone:907-543-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN880011091A101YM0800X
IN88001091A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health