Provider Demographics
NPI:1376099051
Name:MATHESON, SARAH (MA, MA, LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MATHESON
Suffix:
Gender:F
Credentials:MA, MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 N MILLER RD
Mailing Address - Street 2:SUITE 244
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3619
Mailing Address - Country:US
Mailing Address - Phone:602-952-0680
Mailing Address - Fax:480-535-5557
Practice Address - Street 1:4300 N MILLER RD
Practice Address - Street 2:SUITE 244
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3619
Practice Address - Country:US
Practice Address - Phone:602-952-0680
Practice Address - Fax:480-535-5557
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLC-11020101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor