Provider Demographics
NPI:1356903686
Name:THIESSEN, SARAH MARIE (PHD, LCPC, LMHC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIE
Last Name:THIESSEN
Suffix:
Gender:F
Credentials:PHD, LCPC, LMHC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1752 JEWEL BOX DR
Mailing Address - Street 2:
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957-3416
Mailing Address - Country:US
Mailing Address - Phone:410-292-9803
Mailing Address - Fax:
Practice Address - Street 1:1752 JEWEL BOX DR
Practice Address - Street 2:
Practice Address - City:SANIBEL
Practice Address - State:FL
Practice Address - Zip Code:33957-3416
Practice Address - Country:US
Practice Address - Phone:410-292-9803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21376101Y00000X
MDLC9546101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor