Provider Demographics
NPI:1972783603
Name:KERN, SARA M (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:M
Last Name:KERN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2005
Mailing Address - Country:US
Mailing Address - Phone:509-758-3341
Mailing Address - Fax:509-758-8009
Practice Address - Street 1:900 7TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2005
Practice Address - Country:US
Practice Address - Phone:509-758-3341
Practice Address - Fax:509-758-8009
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00053623101Y00000X
WALF 60123708106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00053623OtherREGISTERED COUNSELOR
WALF 60123708OtherMARRIAGE AND FAMILY THERAPY LICENSE