Provider Demographics
NPI:1407414006
Name:VIRCHOW, SARAH J (LIMHP, PLADC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:VIRCHOW
Suffix:
Gender:F
Credentials:LIMHP, PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-2041
Mailing Address - Country:US
Mailing Address - Phone:402-228-3386
Mailing Address - Fax:
Practice Address - Street 1:3901 NORMAL BLVD STE 201
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5250
Practice Address - Country:US
Practice Address - Phone:402-261-4017
Practice Address - Fax:402-261-4137
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)