Provider Demographics
NPI:1619982428
Name:BRINKERHOFF, SARA (LPC, LISAC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BRINKERHOFF
Suffix:
Gender:F
Credentials:LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 W ADAMANDA CT
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-0592
Mailing Address - Country:US
Mailing Address - Phone:623-465-1733
Mailing Address - Fax:623-465-1736
Practice Address - Street 1:1845 S DOBSON RD
Practice Address - Street 2:STE. 204
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5661
Practice Address - Country:US
Practice Address - Phone:602-255-0032
Practice Address - Fax:480-820-6254
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-11527101YA0400X
AZLPC-1112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health