Provider Demographics
NPI:1760623078
Name:STANTON, SARAH M (MED, LMHC, CDP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:STANTON
Suffix:
Gender:F
Credentials:MED, LMHC, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 7TH ST SW
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-7423
Mailing Address - Country:US
Mailing Address - Phone:253-222-8486
Mailing Address - Fax:253-864-4997
Practice Address - Street 1:1819 E 72ND ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-5406
Practice Address - Country:US
Practice Address - Phone:253-222-8486
Practice Address - Fax:253-864-4997
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2012-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60016068101YM0800X
WACP60117058101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)