Provider Demographics
NPI:1093590994
Name:SARA RICHESON LCPC LLC
Entity Type:Organization
Organization Name:SARA RICHESON LCPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHESON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:608-769-1820
Mailing Address - Street 1:5201 FRONTIER DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-8918
Mailing Address - Country:US
Mailing Address - Phone:608-769-1820
Mailing Address - Fax:
Practice Address - Street 1:1601 LEWIS AVE STE 102
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4182
Practice Address - Country:US
Practice Address - Phone:608-769-1820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty