Provider Demographics
NPI:1821435702
Name:ASTRONES, SARAH LARSEN (MAC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LARSEN
Last Name:ASTRONES
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:HILLARY
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1811 W 2ND ST
Mailing Address - Street 2:STE 475
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5413
Mailing Address - Country:US
Mailing Address - Phone:308-850-3509
Mailing Address - Fax:308-381-5698
Practice Address - Street 1:1811 W. 2ND ST.
Practice Address - Street 2:STE. 475
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-5416
Practice Address - Country:US
Practice Address - Phone:308-850-3509
Practice Address - Fax:308-381-5698
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9960101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health