Provider Demographics
NPI:1649697061
Name:ALLEN, SARAH MCCORMICK (MED, LPC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MCCORMICK
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 MCMILLAN ROAD
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29632-0001
Mailing Address - Country:US
Mailing Address - Phone:864-656-2451
Mailing Address - Fax:
Practice Address - Street 1:713 MCMILLAN ROAD
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29632-0001
Practice Address - Country:US
Practice Address - Phone:864-656-2451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC301100Medicaid
SC3333Medicare PIN