Provider Demographics
NPI:1801248364
Name:KERN, SARA LEE (LMHCA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LEE
Last Name:KERN
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JEAN
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHCA
Mailing Address - Street 1:724 2ND AVE S
Mailing Address - Street 2:APT 5
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-6149
Mailing Address - Country:US
Mailing Address - Phone:425-248-7394
Mailing Address - Fax:
Practice Address - Street 1:2119 10TH AVENUE CT SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4058
Practice Address - Country:US
Practice Address - Phone:253-486-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60650140101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health