Provider Demographics
NPI:1780411173
Name:HOTEN, SARA MICHELLE (LGSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MICHELLE
Last Name:HOTEN
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2452 SWEENEYSBURG RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-9712
Mailing Address - Country:US
Mailing Address - Phone:304-902-0179
Mailing Address - Fax:
Practice Address - Street 1:2452 SWEENEYSBURG RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-9712
Practice Address - Country:US
Practice Address - Phone:304-902-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00944397104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker