Provider Demographics
NPI:1245983980
Name:LEISHMAN, SARAH (LMFT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LEISHMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:FAIRBANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:143 RICHDALE LN
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-8306
Mailing Address - Country:US
Mailing Address - Phone:931-224-9596
Mailing Address - Fax:
Practice Address - Street 1:3173 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-7152
Practice Address - Country:US
Practice Address - Phone:615-274-9892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1408106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty