Provider Demographics
NPI:1790421683
Name:NAJAR, SARA (TLLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:NAJAR
Suffix:
Gender:F
Credentials:TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7630 HARMONY CV SE
Mailing Address - Street 2:
Mailing Address - City:BYRON CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49315-8272
Mailing Address - Country:US
Mailing Address - Phone:616-808-1956
Mailing Address - Fax:
Practice Address - Street 1:500 CASCADE WEST PKWY SE STE 240
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2166
Practice Address - Country:US
Practice Address - Phone:616-591-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103T00000X
MI6362009534103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist