Provider Demographics
NPI:1811713852
Name:STALLARD, SARAH G (LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:G
Last Name:STALLARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:G
Other - Last Name:WALDROP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55A PINE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-2546
Mailing Address - Country:US
Mailing Address - Phone:936-697-5503
Mailing Address - Fax:
Practice Address - Street 1:55A PINE RIDGE LN
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-2546
Practice Address - Country:US
Practice Address - Phone:936-697-5503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health