Provider Demographics
NPI:1114253820
Name:NELDEBERG, SARAH E (MS, NCC, PLPC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:NELDEBERG
Suffix:
Gender:F
Credentials:MS, NCC, PLPC
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 MCCLELLAND BLVD
Mailing Address - Street 2:BLDG B STE 207
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1623
Mailing Address - Country:US
Mailing Address - Phone:417-627-9994
Mailing Address - Fax:471-627-9995
Practice Address - Street 1:2700 MCCLELLAND BLVD
Practice Address - Street 2:BLDG B STE 207
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1623
Practice Address - Country:US
Practice Address - Phone:417-627-9994
Practice Address - Fax:471-627-9995
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009032694101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional