Provider Demographics
NPI:1245788074
Name:KITCHENS, SARAH B (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:KITCHENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-4709
Mailing Address - Country:US
Mailing Address - Phone:912-535-2128
Mailing Address - Fax:866-527-5349
Practice Address - Street 1:104 E 2ND ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-4709
Practice Address - Country:US
Practice Address - Phone:912-535-2128
Practice Address - Fax:866-527-5349
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005274101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional