Provider Demographics
NPI:1215041777
Name:ABERG, SARAH C (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:ABERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 S. LAMAR
Mailing Address - Street 2:#416
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215
Mailing Address - Country:US
Mailing Address - Phone:214-668-8355
Mailing Address - Fax:214-421-3740
Practice Address - Street 1:1409 S. LAMAR
Practice Address - Street 2:#416
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215
Practice Address - Country:US
Practice Address - Phone:214-668-8355
Practice Address - Fax:214-421-3740
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX266761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX638819Medicaid
TX00385EOtherBLUE CROSS BLUE SHIELD
TX457606OtherMANAGED HEALTH NETWORK
TX638819Medicaid