Provider Demographics
NPI:1427191246
Name:ANDEREGG, SARA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:ANDEREGG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 HIGHWAY Z
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-4652
Mailing Address - Country:US
Mailing Address - Phone:573-433-5152
Mailing Address - Fax:573-774-4009
Practice Address - Street 1:1400 STATE ROUTE F
Practice Address - Street 2:SUITE 101
Practice Address - City:WAYNESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65583-2831
Practice Address - Country:US
Practice Address - Phone:573-433-5152
Practice Address - Fax:573-774-4009
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004013799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional