Provider Demographics
NPI:1366948671
Name:LADD, SAGAN LEE (MA, LPA)
Entity type:Individual
Prefix:
First Name:SAGAN
Middle Name:LEE
Last Name:LADD
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 OXFORD CT APT 712
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-2109
Mailing Address - Country:US
Mailing Address - Phone:502-612-9129
Mailing Address - Fax:
Practice Address - Street 1:5602 OXFORD CT APT 712
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-2109
Practice Address - Country:US
Practice Address - Phone:502-612-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY240816103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist