Provider Demographics
NPI:1811360852
Name:MEAD, SARAH CLARK (EDM, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CLARK
Last Name:MEAD
Suffix:
Gender:F
Credentials:EDM, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7725 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1905
Mailing Address - Country:US
Mailing Address - Phone:785-218-9351
Mailing Address - Fax:
Practice Address - Street 1:7725 W 87TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1905
Practice Address - Country:US
Practice Address - Phone:785-218-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015029758103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst