Provider Demographics
NPI:1376997569
Name:DIONNE, SARA PAIGE (LLMSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:PAIGE
Last Name:DIONNE
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12797 DENOTER DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-3334
Mailing Address - Country:US
Mailing Address - Phone:586-610-7070
Mailing Address - Fax:
Practice Address - Street 1:13001 23 MILE RD STE 103
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-2767
Practice Address - Country:US
Practice Address - Phone:586-334-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802088900104100000X
MI68011101171041C0700X
MI6851110117104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical