Provider Demographics
NPI:1639521453
Name:BARTZEN, SARAH LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:BARTZEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E MICHIGAN AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3700
Mailing Address - Country:US
Mailing Address - Phone:517-745-3512
Mailing Address - Fax:
Practice Address - Street 1:2301 E MICHIGAN AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3700
Practice Address - Country:US
Practice Address - Phone:517-745-3512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010932001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical