Provider Demographics
NPI:1801567581
Name:MILAM, SARA THANE (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:THANE
Last Name:MILAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:THANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:103 CONTINENTAL PL STE 204
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1041
Mailing Address - Country:US
Mailing Address - Phone:615-208-7187
Mailing Address - Fax:
Practice Address - Street 1:103 CONTINENTAL PL STE 204
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1041
Practice Address - Country:US
Practice Address - Phone:615-208-7187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-495131041C0700X
TN78761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical