Provider Demographics
NPI:1225503493
Name:POINDEXTER, SARA ELEEN (MSW, MHP, SWAICL)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ELEEN
Last Name:POINDEXTER
Suffix:
Gender:F
Credentials:MSW, MHP, SWAICL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W BOONE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2560
Mailing Address - Country:US
Mailing Address - Phone:509-499-4434
Mailing Address - Fax:509-499-4434
Practice Address - Street 1:720 W BOONE AVE STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2560
Practice Address - Country:US
Practice Address - Phone:509-499-4434
Practice Address - Fax:509-499-4434
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC608530171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical