Provider Demographics
NPI:1841558491
Name:CORREA-HEPBURN, SARA MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARIE
Last Name:CORREA-HEPBURN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7165 SW FIR LOOP
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8055
Mailing Address - Country:US
Mailing Address - Phone:503-941-5256
Mailing Address - Fax:503-941-5274
Practice Address - Street 1:7165 SW FIR LOOP
Practice Address - Street 2:SUITE 200
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8055
Practice Address - Country:US
Practice Address - Phone:503-941-5256
Practice Address - Fax:503-941-5274
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL64221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical