Provider Demographics
NPI:1578919064
Name:BEDINGHAUS, SARAH (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BEDINGHAUS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3648
Mailing Address - Street 2:
Mailing Address - City:COEUR D'ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1803 S WOOD DR
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6825
Practice Address - Country:US
Practice Address - Phone:918-756-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC - 6055101YP2500X
OK7146101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional