Provider Demographics
NPI:1174712566
Name:SARVER, ROSEMARY GRACE (LPC/MHSP)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:GRACE
Last Name:SARVER
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 LINDBERGH DR
Mailing Address - Street 2:APT A
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-4030
Mailing Address - Country:US
Mailing Address - Phone:731-298-1845
Mailing Address - Fax:
Practice Address - Street 1:603 LINDBERGH DR
Practice Address - Street 2:APT A
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-4030
Practice Address - Country:US
Practice Address - Phone:731-298-1845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2206101YM0800X
KY0962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
12014791OtherCAQH PROVIDER ID
TN1516397Medicaid
TN4249519OtherBCBST