Provider Demographics
NPI:1609068139
Name:HOCK, SARAH (LIMHP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HOCK
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8134
Mailing Address - Country:US
Mailing Address - Phone:308-237-5951
Mailing Address - Fax:308-234-4018
Practice Address - Street 1:616 W 5TH ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5104
Practice Address - Country:US
Practice Address - Phone:402-463-5684
Practice Address - Fax:402-463-5686
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8409101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47077467428Medicaid