Provider Demographics
NPI:1255065983
Name:HOLDEN, SARA MAY (LPC, NCC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MAY
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 W MARVIN ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-2132
Mailing Address - Country:US
Mailing Address - Phone:208-680-7272
Mailing Address - Fax:
Practice Address - Street 1:1901 N LAKES PL
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-5939
Practice Address - Country:US
Practice Address - Phone:208-890-7165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-09
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-8881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health