Provider Demographics
NPI:1538836010
Name:ESCOBAR, SARAH ANN (LPCC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:ESCOBAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2455 MISSOURI AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5122
Mailing Address - Country:US
Mailing Address - Phone:915-526-6571
Mailing Address - Fax:575-249-5615
Practice Address - Street 1:2455 MISSOURI AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5122
Practice Address - Country:US
Practice Address - Phone:915-526-6571
Practice Address - Fax:575-249-5615
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2023-0252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM22139214Medicaid