Provider Demographics
NPI:1336691021
Name:WESTON, SARA (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:WESTON
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 TRAVIS GREEN LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6269
Mailing Address - Country:US
Mailing Address - Phone:512-826-3366
Mailing Address - Fax:
Practice Address - Street 1:5805 TRAVIS GREEN LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6269
Practice Address - Country:US
Practice Address - Phone:512-826-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67436101YP2500X
TX201699106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional