Provider Demographics
NPI:1811689987
Name:O'TOOLE, SARA (LMSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:O'TOOLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 PERRY ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-2762
Mailing Address - Country:US
Mailing Address - Phone:231-288-9355
Mailing Address - Fax:
Practice Address - Street 1:6918 SHALLOWFORD RD STE 317
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1783
Practice Address - Country:US
Practice Address - Phone:423-855-7977
Practice Address - Fax:423-855-7976
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN132691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical