Provider Demographics
NPI:1568863694
Name:EIDEMILLER, SARAH MARIE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:MARIE
Last Name:EIDEMILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BEL AIR DR APT 1204
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7706
Mailing Address - Country:US
Mailing Address - Phone:724-858-9854
Mailing Address - Fax:
Practice Address - Street 1:1 NORTHGATE SQ STE 101B
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1377
Practice Address - Country:US
Practice Address - Phone:724-858-9854
Practice Address - Fax:724-672-9078
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PACW0200051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor