Provider Demographics
NPI:1922377225
Name:WHITEWATER, SARAH P (MS, LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:P
Last Name:WHITEWATER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 NW 21ST ST STE 107
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-1861
Mailing Address - Country:US
Mailing Address - Phone:405-999-7525
Mailing Address - Fax:
Practice Address - Street 1:616 NW 21ST ST STE 107
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1861
Practice Address - Country:US
Practice Address - Phone:405-999-7525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7013101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional