Provider Demographics
NPI:1336477090
Name:HOUSTON, SARAH (MA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 147
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:VT
Mailing Address - Zip Code:05843-9655
Mailing Address - Country:US
Mailing Address - Phone:802-472-6642
Mailing Address - Fax:
Practice Address - Street 1:39 CHURCH ST.
Practice Address - Street 2:WELLSPRING
Practice Address - City:HARDWICK
Practice Address - State:VT
Practice Address - Zip Code:05843-9655
Practice Address - Country:US
Practice Address - Phone:802-472-6642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097-0000053101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health