Provider Demographics
NPI:1326415712
Name:CARPENTER, SARAH (LPC,SEP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LPC,SEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17049 TRAIL OF THE WOODS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78734-1045
Mailing Address - Country:US
Mailing Address - Phone:512-522-4618
Mailing Address - Fax:
Practice Address - Street 1:17049 TRAIL OF THE WOODS
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78734-1045
Practice Address - Country:US
Practice Address - Phone:512-522-4618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional