Provider Demographics
NPI:1922434281
Name:SARNS, SAMUEL GEORGE (MA)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:GEORGE
Last Name:SARNS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 VETERANS DR STE 126
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4564
Mailing Address - Country:US
Mailing Address - Phone:231-392-2559
Mailing Address - Fax:
Practice Address - Street 1:3301 VETERANS DR STE 126
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4564
Practice Address - Country:US
Practice Address - Phone:231-392-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI301014308103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling