Provider Demographics
NPI:1013689777
Name:ROOS, SARAH KRISTINE (LP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:KRISTINE
Last Name:ROOS
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:LIPPERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2821 KLEMPNER WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-4203
Mailing Address - Country:US
Mailing Address - Phone:502-452-6341
Mailing Address - Fax:502-452-6718
Practice Address - Street 1:2821 KLEMPNER WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-4203
Practice Address - Country:US
Practice Address - Phone:502-452-6341
Practice Address - Fax:502-452-6718
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY277579103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical