Provider Demographics
NPI:1801827183
Name:KIRK, SARAH BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BETH
Last Name:KIRK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 E 350TH RD
Mailing Address - Street 2:
Mailing Address - City:LECOMPTON
Mailing Address - State:KS
Mailing Address - Zip Code:66050-4040
Mailing Address - Country:US
Mailing Address - Phone:785-864-9853
Mailing Address - Fax:
Practice Address - Street 1:1415 JAYHAWK BLVD
Practice Address - Street 2:KU PSYCHOLOGICAL CLINIC, FRASER HALL
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-7556
Practice Address - Country:US
Practice Address - Phone:785-864-9853
Practice Address - Fax:785-864-5696
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1052103TC0700X
MO1939103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical