Provider Demographics
NPI:1760940027
Name:PERRAULT, SARAH ANN (LCPC, LAC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANN
Last Name:PERRAULT
Suffix:
Gender:F
Credentials:LCPC, LAC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-0362
Mailing Address - Country:US
Mailing Address - Phone:406-230-1397
Mailing Address - Fax:406-433-3586
Practice Address - Street 1:1405 4TH ST SW
Practice Address - Street 2:SUITE 2
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270
Practice Address - Country:US
Practice Address - Phone:406-643-4095
Practice Address - Fax:406-433-3586
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-38100101YA0400X
MTBBH-PCLC-LIC-31487101YM0800X
MTBBH-ACLC-LIC-30295101YA0400X
MTBBH-LCPC-LIC-44272101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT100001540Medicaid