Provider Demographics
NPI:1396182473
Name:JOHNSON, SARAH J (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1733 W 33RD ST STE 120
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3866
Mailing Address - Country:US
Mailing Address - Phone:405-921-7655
Mailing Address - Fax:
Practice Address - Street 1:1733 W 33RD ST STE 120
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3866
Practice Address - Country:US
Practice Address - Phone:405-921-7655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1396182473Medicaid