Provider Demographics
NPI:1780207886
Name:BRASFIELD, SARAH DAYTON GAMBLE (NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:DAYTON GAMBLE
Last Name:BRASFIELD
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:DAYTON GAMBLE
Other - Last Name:BRASFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, NCC, LPC
Mailing Address - Street 1:100 STARR AVE STE A
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-4032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 STARR AVE STE A
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-4032
Practice Address - Country:US
Practice Address - Phone:662-498-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2408101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health