Provider Demographics
NPI:1770025553
Name:FARLOUGH, SARAH J (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:FARLOUGH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JENICA
Other - Last Name:FARLOUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1112A E ASCENSION COMPLEX
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-0000
Mailing Address - Country:US
Mailing Address - Phone:225-450-1167
Mailing Address - Fax:225-450-1153
Practice Address - Street 1:11990 JACKSON ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:LA
Practice Address - Zip Code:70722-3210
Practice Address - Country:US
Practice Address - Phone:225-683-5292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
LA137891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA13789OtherLOUISIANA STATE BOARD OF SOCIAL WORKERS