Provider Demographics
NPI:1508091810
Name:DIMOCK, SARAH (MA MED LMHC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DIMOCK
Suffix:
Gender:F
Credentials:MA MED LMHC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:WALSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA MED LMHC
Mailing Address - Street 1:1569 NE 177TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-5230
Mailing Address - Country:US
Mailing Address - Phone:206-933-8696
Mailing Address - Fax:
Practice Address - Street 1:1569 NE 177TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-5230
Practice Address - Country:US
Practice Address - Phone:206-933-8696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-17
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60045344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health