Provider Demographics
NPI:1770398547
Name:DAVIS, SARAH JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:HUFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1521 HINOTE RD
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32433-8130
Mailing Address - Country:US
Mailing Address - Phone:850-376-1468
Mailing Address - Fax:
Practice Address - Street 1:1521 HINOTE RD
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32433-8130
Practice Address - Country:US
Practice Address - Phone:850-376-1468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW164171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical