Provider Demographics
NPI:1871967406
Name:WHITLEDGE, SARAH L (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:WHITLEDGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:WHITLEDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:1111 SHIVE LN STE 104
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-8051
Mailing Address - Country:US
Mailing Address - Phone:270-576-3303
Mailing Address - Fax:270-517-0300
Practice Address - Street 1:624 EASTWOOD STREET
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103
Practice Address - Country:US
Practice Address - Phone:270-202-8869
Practice Address - Fax:270-517-0300
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
KY50251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical