Provider Demographics
NPI:1275893679
Name:HUMMEL, SARAH E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:HUMMEL
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 1:1121 ESE LOOP323
Mailing Address - Street 2:204
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-9660
Mailing Address - Country:US
Mailing Address - Phone:903-581-3977
Mailing Address - Fax:
Practice Address - Street 1:1121 ESE LOOP323
Practice Address - Street 2:204
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9660
Practice Address - Country:US
Practice Address - Phone:903-581-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX532231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical