Provider Demographics
NPI:1144847849
Name:GARR, SADE ANGELA (MA, LCPC)
Entity type:Individual
Prefix:
First Name:SADE
Middle Name:ANGELA
Last Name:GARR
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:SADE
Other - Middle Name:ANGELA
Other - Last Name:TYLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:601 N MUR LEN RD STE 12A
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5425
Mailing Address - Country:US
Mailing Address - Phone:888-913-7872
Mailing Address - Fax:913-273-4820
Practice Address - Street 1:601 N MUR LEN RD STE 12A
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5425
Practice Address - Country:US
Practice Address - Phone:888-913-7872
Practice Address - Fax:913-273-4820
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3641101YM0800X, 101Y00000X
KS03889101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30004707180002Medicaid