Provider Demographics
NPI:1588011472
Name:MORTON, SARAH CHRISTINA MCMAHAN (LLP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:CHRISTINA MCMAHAN
Last Name:MORTON
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:CHRISTINA MCMAHAN
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41700 GARDENBROOK RD STE 110
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1320
Mailing Address - Country:US
Mailing Address - Phone:248-692-4890
Mailing Address - Fax:
Practice Address - Street 1:41700 GARDENBROOK RD STE 110
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1320
Practice Address - Country:US
Practice Address - Phone:248-692-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016693103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist