Provider Demographics
NPI:1477047033
Name:RICHTER, SARAH MARIE (LLMSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:RICHTER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:MR
Other - First Name:EZRA
Other - Middle Name:NYLE
Other - Last Name:RICHTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLMSW
Mailing Address - Street 1:233 FULTON ST E STE 222
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-3262
Mailing Address - Country:US
Mailing Address - Phone:616-490-3468
Mailing Address - Fax:616-369-1281
Practice Address - Street 1:233 FULTON ST E STE 222
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-3262
Practice Address - Country:US
Practice Address - Phone:616-490-3468
Practice Address - Fax:616-369-1281
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 3747P1801X
MI68511164291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant