Provider Demographics
NPI:1518369164
Name:STORIE, SARAH OLIVIA (LMHC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:OLIVIA
Last Name:STORIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:OLIVIA
Other - Last Name:SHYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1003 COTTONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-1012
Mailing Address - Country:US
Mailing Address - Phone:641-782-8457
Mailing Address - Fax:641-782-7048
Practice Address - Street 1:1003 COTTONWOOD RD
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1012
Practice Address - Country:US
Practice Address - Phone:641-782-8457
Practice Address - Fax:641-782-7048
Is Sole Proprietor?:No
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional