Provider Demographics
NPI:1477092583
Name:ADAM, SARAH ELIZABETH (CSW, QMHP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:ADAM
Suffix:
Gender:
Credentials:CSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 W MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2575
Mailing Address - Country:US
Mailing Address - Phone:605-303-6942
Mailing Address - Fax:605-569-7965
Practice Address - Street 1:1719 W MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2575
Practice Address - Country:US
Practice Address - Phone:605-303-6942
Practice Address - Fax:605-569-7965
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6442104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker