Provider Demographics
NPI:1205011202
Name:REA, SARAH (LPC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:REA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:SKINNER
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 FIVE MILE RD
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-9233
Mailing Address - Country:US
Mailing Address - Phone:734-255-0585
Mailing Address - Fax:
Practice Address - Street 1:815 FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:WHITMORE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48189-9233
Practice Address - Country:US
Practice Address - Phone:734-255-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional