Provider Demographics
NPI:1629559570
Name:GIDEON, SARAH ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:GIDEON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 WEST ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-4945
Mailing Address - Country:US
Mailing Address - Phone:512-739-6800
Mailing Address - Fax:
Practice Address - Street 1:406 WEST ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-4945
Practice Address - Country:US
Practice Address - Phone:512-739-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77259101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health