Provider Demographics
NPI:1396874186
Name:DAVES, SARA L (LPC & LMFT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:DAVES
Suffix:
Gender:F
Credentials:LPC & LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 W LINDSEY ST
Mailing Address - Street 2:SUITE C-120
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4159
Mailing Address - Country:US
Mailing Address - Phone:405-366-8828
Mailing Address - Fax:405-325-1478
Practice Address - Street 1:1818 W LINDSEY ST
Practice Address - Street 2:SUITE C-120
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4159
Practice Address - Country:US
Practice Address - Phone:405-366-8828
Practice Address - Fax:405-325-1478
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK285106H00000X
OK115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731312559 02OtherHEALTHCHOICE PROVIDER