Provider Demographics
NPI:1255475802
Name:LAUTENSCHLAGER, SARA BETH (MSW, LMHP, LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:BETH
Last Name:LAUTENSCHLAGER
Suffix:
Gender:F
Credentials:MSW, LMHP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 N KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4470
Mailing Address - Country:US
Mailing Address - Phone:402-461-0355
Mailing Address - Fax:
Practice Address - Street 1:207 N PINE ST
Practice Address - Street 2:SUITE # 106
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-5900
Practice Address - Country:US
Practice Address - Phone:308-379-4179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3030101YM0800X
NE11981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical