Provider Demographics
NPI:1417660424
Name:SMITH, SARA MARIE (MA, LLMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 INDEPENDENCE ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-2308
Mailing Address - Country:US
Mailing Address - Phone:269-350-3449
Mailing Address - Fax:269-649-7324
Practice Address - Street 1:107 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-1760
Practice Address - Country:US
Practice Address - Phone:269-350-3449
Practice Address - Fax:269-649-7324
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4151001087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist