Provider Demographics
NPI:1669511705
Name:CRANDALL, SARA ANN (MSW LMHP LCSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:ANN
Last Name:CRANDALL
Suffix:
Gender:F
Credentials:MSW LMHP LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 CORNHUSKER HWY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-1534
Mailing Address - Country:US
Mailing Address - Phone:402-464-8866
Mailing Address - Fax:402-464-8879
Practice Address - Street 1:3940 CORNHUSKER HWY
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-1534
Practice Address - Country:US
Practice Address - Phone:402-464-8866
Practice Address - Fax:402-464-8879
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2965101YM0800X
NE1185101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE250100OtherMIDLANDS CHOICE
NE85486OtherBCBS