Provider Demographics
NPI:1891037420
Name:THOMPSON, SARAH ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:THOMPSON
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 1:113 TOMAHAWK LN
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:IN
Mailing Address - Zip Code:47920-9751
Mailing Address - Country:US
Mailing Address - Phone:765-409-6427
Mailing Address - Fax:
Practice Address - Street 1:1700 E 38TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4568
Practice Address - Country:US
Practice Address - Phone:765-472-8916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006408A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical