Provider Demographics
NPI:1558464115
Name:HESSENAUER, SARAH LOUISE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LOUISE
Last Name:HESSENAUER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LOUISE
Other - Last Name:SHERIDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSW CADE III
Mailing Address - Street 1:17 S. RIVER ST.
Mailing Address - Street 2:SUITE 254
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548
Mailing Address - Country:US
Mailing Address - Phone:608-755-5260
Mailing Address - Fax:608-755-5267
Practice Address - Street 1:17 S. RIVER ST
Practice Address - Street 2:SUITE 254
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548
Practice Address - Country:US
Practice Address - Phone:608-755-5260
Practice Address - Fax:608-755-5267
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3043123104100000X
WI3043-123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39646000Medicaid