Provider Demographics
NPI:1487064713
Name:DR. SARA L. THOMASON, PSYD, PLLC
Entity type:Organization
Organization Name:DR. SARA L. THOMASON, PSYD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:LINDSAY
Authorized Official - Last Name:THOMASON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:774-419-1041
Mailing Address - Street 1:23 ISAAC ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-2080
Mailing Address - Country:US
Mailing Address - Phone:774-419-1041
Mailing Address - Fax:774-419-1044
Practice Address - Street 1:23 ISAAC ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2080
Practice Address - Country:US
Practice Address - Phone:774-419-1041
Practice Address - Fax:774-419-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9192103TB0200X, 103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty