Provider Demographics
NPI:1508471483
Name:WIRTH, SARAH ANN-MCCONNELL (BA, BS)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN-MCCONNELL
Last Name:WIRTH
Suffix:
Gender:F
Credentials:BA, BS
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Mailing Address - Street 1:5200 CROYDEN AVE APT 14105
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-3369
Mailing Address - Country:US
Mailing Address - Phone:269-325-7226
Mailing Address - Fax:
Practice Address - Street 1:1000 OAKLAND DR FL 3
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-1282
Practice Address - Country:US
Practice Address - Phone:269-387-8230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)