Provider Demographics
NPI:1821431792
Name:MAST, SARAH FAEHNLE (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:FAEHNLE
Last Name:MAST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 N. LAMAR RD.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4025
Mailing Address - Country:US
Mailing Address - Phone:512-656-3163
Mailing Address - Fax:
Practice Address - Street 1:3906 N LAMAR BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4025
Practice Address - Country:US
Practice Address - Phone:512-656-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX501061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical