Provider Demographics
NPI:1326146903
Name:WYSOCKI, SARA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:WYSOCKI
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 1:798 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-3014
Mailing Address - Country:US
Mailing Address - Phone:724-622-7669
Mailing Address - Fax:
Practice Address - Street 1:3200 PARK LN
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275
Practice Address - Country:US
Practice Address - Phone:888-244-6293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor