Provider Demographics
NPI:1497986442
Name:BRAUN, SARAH (LADC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BRAUN
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 KELLOGG ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4370
Mailing Address - Country:US
Mailing Address - Phone:207-939-8948
Mailing Address - Fax:
Practice Address - Street 1:17 BISHOP ST FL 2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103
Practice Address - Country:US
Practice Address - Phone:207-893-0386
Practice Address - Fax:207-893-2086
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC3916101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)