Provider Demographics
NPI:1023650538
Name:MCDERMOTT, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:ID
Mailing Address - Zip Code:83313-6068
Mailing Address - Country:US
Mailing Address - Phone:208-788-0146
Mailing Address - Fax:
Practice Address - Street 1:733 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:ID
Practice Address - Zip Code:83313-6068
Practice Address - Country:US
Practice Address - Phone:208-788-0146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor