Provider Demographics
NPI:1710438809
Name:DELOACH, SARAH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:DELOACH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 BRECKENRIDGE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1385
Mailing Address - Country:US
Mailing Address - Phone:270-215-4000
Mailing Address - Fax:
Practice Address - Street 1:2707 BRECKENRIDGE ST STE 4
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1385
Practice Address - Country:US
Practice Address - Phone:270-215-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2521881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical