Provider Demographics
NPI:1073112355
Name:MENDELSSOHN, SARAH NICOLE (MS, LLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLE
Last Name:MENDELSSOHN
Suffix:
Gender:F
Credentials:MS, LLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:NICOLE
Other - Last Name:KESLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23231 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1361
Mailing Address - Country:US
Mailing Address - Phone:248-325-8199
Mailing Address - Fax:
Practice Address - Street 1:230 COLLINGWOOD ST STE 250
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3845
Practice Address - Country:US
Practice Address - Phone:248-325-8199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009224103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist