Provider Demographics
NPI:1164999587
Name:STENERSEN, SARA M (LMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:STENERSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 17TH AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4613
Mailing Address - Country:US
Mailing Address - Phone:509-496-5453
Mailing Address - Fax:
Practice Address - Street 1:2913 E MADISON ST STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4213
Practice Address - Country:US
Practice Address - Phone:541-250-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60962028106H00000X
WALF61209043106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist