Provider Demographics
NPI:1568932093
Name:FIELDING, SARAH LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:FIELDING
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 1:344 SPEEDWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-5469
Mailing Address - Country:US
Mailing Address - Phone:406-207-7379
Mailing Address - Fax:
Practice Address - Street 1:112 W FRONT ST STE 206
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4304
Practice Address - Country:US
Practice Address - Phone:406-207-7379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-334811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical