Provider Demographics
NPI:1154452621
Name:ROLL, SARA PETERS (MSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:PETERS
Last Name:ROLL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 13TH ST STE 2540
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-1305
Mailing Address - Country:US
Mailing Address - Phone:812-372-3745
Mailing Address - Fax:812-372-5367
Practice Address - Street 1:1531 13TH ST STE 2540
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-1305
Practice Address - Country:US
Practice Address - Phone:812-372-3745
Practice Address - Fax:812-372-5367
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health