Provider Demographics
NPI:1669508644
Name:RAFFERTY, SARA (LMHC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:RAFFERTY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 BLACK WILLOW TRL
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-1156
Mailing Address - Country:US
Mailing Address - Phone:407-927-0937
Mailing Address - Fax:407-682-4405
Practice Address - Street 1:375 DOUGLAS AVE STE 2005
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3315
Practice Address - Country:US
Practice Address - Phone:407-529-5359
Practice Address - Fax:407-682-4405
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health