Provider Demographics
NPI:1740521558
Name:LANDERS, SARAH ELLA GENE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELLA GENE
Last Name:LANDERS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELLA GENE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:628 COUNTY ROAD 327
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-9395
Mailing Address - Country:US
Mailing Address - Phone:573-518-7479
Mailing Address - Fax:573-733-6448
Practice Address - Street 1:628 COUNTY ROAD 327
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-9395
Practice Address - Country:US
Practice Address - Phone:573-518-7479
Practice Address - Fax:573-733-6448
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190233281041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical