Provider Demographics
NPI:1255667754
Name:BENNETT, SARAH RABB (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RABB
Last Name:BENNETT
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 1:12880 HILLCREST RD
Mailing Address - Street 2:SUITE #224
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1532
Mailing Address - Country:US
Mailing Address - Phone:972-991-4534
Mailing Address - Fax:972-490-3567
Practice Address - Street 1:12880 HILLCREST RD
Practice Address - Street 2:SUITE 224
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1532
Practice Address - Country:US
Practice Address - Phone:972-991-4534
Practice Address - Fax:972-490-3567
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102L00000X
TX141041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst