Provider Demographics
NPI:1033286547
Name:THIBAULT, SARAH ELIZABETH (PLCSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:THIBAULT
Suffix:
Gender:F
Credentials:PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-2970
Mailing Address - Country:US
Mailing Address - Phone:816-523-0356
Mailing Address - Fax:
Practice Address - Street 1:9700 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64137-1135
Practice Address - Country:US
Practice Address - Phone:816-508-3400
Practice Address - Fax:816-508-3425
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060164281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical