Provider Demographics
NPI:1295039428
Name:VINSON, SARAH DENISE (LCSW, SAC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:DENISE
Last Name:VINSON
Suffix:
Gender:F
Credentials:LCSW, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 TRIVERTON PIKE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-7514
Mailing Address - Country:US
Mailing Address - Phone:608-400-1708
Mailing Address - Fax:608-709-8066
Practice Address - Street 1:2960 TRIVERTON PIKE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-7514
Practice Address - Country:US
Practice Address - Phone:608-400-3818
Practice Address - Fax:608-709-8066
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15457-130101YA0400X
WI127936-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)