Provider Demographics
NPI:1831830207
Name:CARSE, SARA ALEXANDRIA (MS)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ALEXANDRIA
Last Name:CARSE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 E HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2930
Mailing Address - Country:US
Mailing Address - Phone:815-735-1819
Mailing Address - Fax:
Practice Address - Street 1:1932 E HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2930
Practice Address - Country:US
Practice Address - Phone:815-735-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3001023782103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool