Provider Demographics
NPI:1538285853
Name:BARTRAM, SARA R (MMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:R
Last Name:BARTRAM
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 KEENE VLY N
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4594
Mailing Address - Country:US
Mailing Address - Phone:615-403-1036
Mailing Address - Fax:
Practice Address - Street 1:100 HAZEL PATH
Practice Address - Street 2:LEXINGTON BUILDING, SUITE B
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3841
Practice Address - Country:US
Practice Address - Phone:615-403-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLMT0000001032106H00000X
CAMFC52176106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist