Provider Demographics
NPI:1912087917
Name:CARLBLOM, SARAH ANN (MAPC, LAC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANN
Last Name:CARLBLOM
Suffix:
Gender:F
Credentials:MAPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 N 7TH AVE
Mailing Address - Street 2:CHRISTIAN FAMILY CARE AGENCY
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3638
Mailing Address - Country:US
Mailing Address - Phone:602-234-1935
Mailing Address - Fax:602-234-0022
Practice Address - Street 1:3603 N 7TH AVE
Practice Address - Street 2:CHRISTIAN FAMILY CARE AGENCY
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3638
Practice Address - Country:US
Practice Address - Phone:602-234-1935
Practice Address - Fax:602-234-0022
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-12173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional