Provider Demographics
NPI:1225047228
Name:SEMMELROTH, SARA (MSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SEMMELROTH
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 1:3219 LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2003
Mailing Address - Country:US
Mailing Address - Phone:269-373-5407
Mailing Address - Fax:
Practice Address - Street 1:298 W LOCKWOOD RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-9351
Practice Address - Country:US
Practice Address - Phone:517-279-8123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010096861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical