Provider Demographics
NPI:1912434077
Name:GORRELL, SARAH WILLIAMS (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:WILLIAMS
Last Name:GORRELL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 AMITY ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-3605
Mailing Address - Country:US
Mailing Address - Phone:479-981-1587
Mailing Address - Fax:
Practice Address - Street 1:21 AMITY ST
Practice Address - Street 2:
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632-3605
Practice Address - Country:US
Practice Address - Phone:479-981-1587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-18
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR841-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR841-COtherARKANSAS SOCIAL WORK LICENSING BOARD