Provider Demographics
NPI:1710608658
Name:SARGENT, JADYN LYNN (LMSW)
Entity type:Individual
Prefix:MS
First Name:JADYN
Middle Name:LYNN
Last Name:SARGENT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 W HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-7680
Mailing Address - Country:US
Mailing Address - Phone:208-699-9896
Mailing Address - Fax:
Practice Address - Street 1:1250 W IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2679
Practice Address - Country:US
Practice Address - Phone:208-446-6430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker