Provider Demographics
NPI:1265393375
Name:STAHL, SARA JANE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JANE
Last Name:STAHL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 KOTERAS DR
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9562
Mailing Address - Country:US
Mailing Address - Phone:616-218-5176
Mailing Address - Fax:
Practice Address - Street 1:1981 KOTERAS DR
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9562
Practice Address - Country:US
Practice Address - Phone:616-218-5176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010849441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical