Provider Demographics
NPI:1932316742
Name:BOOGAARD, SARA FEBREY (MS, CAS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:FEBREY
Last Name:BOOGAARD
Suffix:
Gender:F
Credentials:MS, CAS, LMHC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:FEBREY
Other - Last Name:BOOGAARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CAS, LMHC
Mailing Address - Street 1:7488 GARNER RD
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:NY
Mailing Address - Zip Code:14590-9319
Mailing Address - Country:US
Mailing Address - Phone:315-879-7603
Mailing Address - Fax:
Practice Address - Street 1:5 W CAYUGA ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2031
Practice Address - Country:US
Practice Address - Phone:315-342-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001047101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health