Provider Demographics
NPI:1558027789
Name:JONES, SARA F (IADC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:F
Last Name:JONES
Suffix:
Gender:F
Credentials:IADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 S MAIN ST STE 1E
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4189
Mailing Address - Country:US
Mailing Address - Phone:605-225-1010
Mailing Address - Fax:605-725-8055
Practice Address - Street 1:14 S MAIN ST STE 1E
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4189
Practice Address - Country:US
Practice Address - Phone:605-225-1010
Practice Address - Fax:605-725-8055
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21R018101YA0400X
SD21031865101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA421323808Medicaid