Provider Demographics
NPI:1396449435
Name:RAFFERTY, SARAH (MSN, MA, PMHNP, LCPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RAFFERTY
Suffix:
Gender:F
Credentials:MSN, MA, PMHNP, LCPC
Other - Prefix:
Other - First Name:SE
Other - Middle Name:
Other - Last Name:RAFFERTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, MA, PMHNP, LCPC
Mailing Address - Street 1:100 HERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PEAKS ISLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04108-1232
Mailing Address - Country:US
Mailing Address - Phone:303-442-3947
Mailing Address - Fax:
Practice Address - Street 1:32 YORK ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1309
Practice Address - Country:US
Practice Address - Phone:207-351-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP231023363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health