Provider Demographics
NPI:1124181144
Name:BRUHN, SARA D (LCSW LPC LMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:D
Last Name:BRUHN
Suffix:
Gender:F
Credentials:LCSW LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 LAKE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-5626
Mailing Address - Country:US
Mailing Address - Phone:936-291-7928
Mailing Address - Fax:936-294-0164
Practice Address - Street 1:2804 LAKE RD STE 1
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-5626
Practice Address - Country:US
Practice Address - Phone:936-291-7928
Practice Address - Fax:936-294-0164
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00038604261106H00000X
TX060301041C0700X
TX5061101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX562JOtherBCBS
TX064171401Medicaid