Provider Demographics
NPI:1659729390
Name:TYLER, SARA A (LSCW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:A
Last Name:TYLER
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N PROVIDENCE RD STE 327
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-3710
Mailing Address - Country:US
Mailing Address - Phone:573-530-7953
Mailing Address - Fax:
Practice Address - Street 1:1900 N PROVIDENCE RD STE 327
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-3710
Practice Address - Country:US
Practice Address - Phone:573-530-7953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070344231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical