Provider Demographics
NPI:1356717888
Name:KING, SARA L (LPC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:KING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 WENTWORTH DR
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-6514
Mailing Address - Country:US
Mailing Address - Phone:479-544-0191
Mailing Address - Fax:479-239-8523
Practice Address - Street 1:5212 W VILLAGE PKWY STE 1
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8190
Practice Address - Country:US
Practice Address - Phone:479-544-0191
Practice Address - Fax:479-239-8523
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2021-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1902022101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional