Provider Demographics
NPI:1164279691
Name:ABBOTT, SARAH D (LPC-A)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:D
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 SHAKER RD STE 7
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3110
Mailing Address - Country:US
Mailing Address - Phone:860-698-3061
Mailing Address - Fax:
Practice Address - Street 1:72 SHAKER RD STE 7
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3110
Practice Address - Country:US
Practice Address - Phone:860-698-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6321101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health