Provider Demographics
NPI:1225882939
Name:WHITE, SARAH SHADAE (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SHADAE
Last Name:WHITE
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 1:8105 SHOAL CREEK BLVD # B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-8040
Mailing Address - Country:US
Mailing Address - Phone:512-524-5482
Mailing Address - Fax:
Practice Address - Street 1:8105 SHOAL CREEK BLVD # B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-8040
Practice Address - Country:US
Practice Address - Phone:512-524-5482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical