Provider Demographics
NPI:1073781316
Name:CARNEY, SARAH ELIZABETH (MED FAAA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:CARNEY
Suffix:
Gender:F
Credentials:MED FAAA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6143
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-6143
Mailing Address - Country:US
Mailing Address - Phone:317-844-7059
Mailing Address - Fax:317-819-0044
Practice Address - Street 1:11725 N ILLINOIS ST
Practice Address - Street 2:STE 445
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3008
Practice Address - Country:US
Practice Address - Phone:317-844-7059
Practice Address - Fax:317-819-0044
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002489A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL600565900Medicaid
IN000000745716OtherANTHEM PROVIDER NUMBER
FLP00687517OtherRR MEDICARE
IN000000745716OtherANTHEM PROVIDER NUMBER
INM400062245Medicare PIN
FLAJ913ZMedicare PIN