Provider Demographics
NPI:1942958293
Name:AUSTIN, SARA BETH (MA, NCC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:BETH
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 SW YAMHILL ST STE 345
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1326
Mailing Address - Country:US
Mailing Address - Phone:503-715-2060
Mailing Address - Fax:
Practice Address - Street 1:520 SW YAMHILL ST STE 345
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1326
Practice Address - Country:US
Practice Address - Phone:503-715-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR7116101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health