Provider Demographics
NPI:1659969921
Name:WOODS, SARAH MARIE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:WOODS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 MOUNT PLEASANT LN
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-3944
Mailing Address - Country:US
Mailing Address - Phone:309-634-9734
Mailing Address - Fax:
Practice Address - Street 1:5801 MOUNT PLEASANT LN
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-3944
Practice Address - Country:US
Practice Address - Phone:309-634-9734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-24-78139103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst