Provider Demographics
NPI:1013425669
Name:COGLIANO, SARAH LARISSA (LCPC-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LARISSA
Last Name:COGLIANO
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 484
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04732-0484
Mailing Address - Country:US
Mailing Address - Phone:703-774-8846
Mailing Address - Fax:
Practice Address - Street 1:12 DESPRES ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:ME
Practice Address - Zip Code:04732-3261
Practice Address - Country:US
Practice Address - Phone:703-774-8846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL8270101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional