Provider Demographics
NPI:1184390494
Name:STUTEVILLE, SARAH ROSE (LMHCA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:STUTEVILLE
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4814
Mailing Address - Country:US
Mailing Address - Phone:901-206-4785
Mailing Address - Fax:
Practice Address - Street 1:722 23RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4814
Practice Address - Country:US
Practice Address - Phone:901-206-4785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health