Provider Demographics
NPI:1164031977
Name:TIPTON, SARAH MECHOLSKY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MECHOLSKY
Last Name:TIPTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:RACHEL
Other - Last Name:MECHOLSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10508 N GLENSTONE PL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2838
Mailing Address - Country:US
Mailing Address - Phone:225-405-5861
Mailing Address - Fax:
Practice Address - Street 1:10508 N GLENSTONE PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2838
Practice Address - Country:US
Practice Address - Phone:225-405-5861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional