Provider Demographics
NPI:1770729592
Name:SPLINTER, SARAH L (LCSW, MSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:SPLINTER
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:LOESCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:437 S YELLOWSTONE DR
Mailing Address - Street 2:STE 220
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1061
Mailing Address - Country:US
Mailing Address - Phone:608-516-4347
Mailing Address - Fax:
Practice Address - Street 1:N2846 STATE ROAD 67
Practice Address - Street 2:
Practice Address - City:WILLIAMS BAY
Practice Address - State:WI
Practice Address - Zip Code:53191-3771
Practice Address - Country:US
Practice Address - Phone:262-245-5608
Practice Address - Fax:262-245-5648
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7694-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1770729592OtherBCBSWI
WI1770729592Medicaid
WISPLINSAROtherMERCYCARE INSURANCE
WI1770729592Medicaid