Provider Demographics
NPI:1114399110
Name:SARAH LONGSON MFT
Entity Type:Organization
Organization Name:SARAH LONGSON MFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:702-449-9001
Mailing Address - Street 1:3501 W CHARLESTON BLVD
Mailing Address - Street 2:#100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1839
Mailing Address - Country:US
Mailing Address - Phone:702-449-9001
Mailing Address - Fax:844-872-4570
Practice Address - Street 1:3501 W CHARLESTON BLVD
Practice Address - Street 2:#100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1839
Practice Address - Country:US
Practice Address - Phone:702-449-9001
Practice Address - Fax:844-872-4570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01337106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty