Provider Demographics
NPI:1740845387
Name:ANSELL, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ANSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 RAILROAD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-1547
Mailing Address - Country:US
Mailing Address - Phone:570-293-9599
Mailing Address - Fax:
Practice Address - Street 1:418 RAILROAD ST STE 101
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-1547
Practice Address - Country:US
Practice Address - Phone:570-293-9599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015387101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional