Provider Demographics
NPI:1417398140
Name:HELMER, SARA L (LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:HELMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 BLAINE ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-4343
Mailing Address - Country:US
Mailing Address - Phone:208-454-3430
Mailing Address - Fax:888-972-1962
Practice Address - Street 1:2006 BLAINE ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-4343
Practice Address - Country:US
Practice Address - Phone:208-454-3430
Practice Address - Fax:208-453-6493
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID355061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710427513OtherTYPE II NPI
ID126556547Medicaid
ID1417398140Medicaid