Provider Demographics
NPI:1568728087
Name:STEVENS, SARAH RACHEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:RACHEL
Last Name:STEVENS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:RACHEL
Other - Last Name:JARVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5170 US RT 60 EAST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-1642
Mailing Address - Country:US
Mailing Address - Phone:304-528-4600
Mailing Address - Fax:
Practice Address - Street 1:5170 US RT 60 EAST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-1642
Practice Address - Country:US
Practice Address - Phone:304-528-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1051103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0067478Medicaid
WV3810023443Medicaid
KY7100316220Medicaid
WVQ39971C197Medicare PIN
WVQ39971BMedicare PIN
WVQ39971C604Medicare PIN
WVQ39971AMedicare PIN