Provider Demographics
NPI:1548030257
Name:LICHSTEIN, SARA (MA LMFT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LICHSTEIN
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 15TH ST APT 104
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3349
Mailing Address - Country:US
Mailing Address - Phone:818-208-0134
Mailing Address - Fax:
Practice Address - Street 1:1537 15TH ST APT 104
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3349
Practice Address - Country:US
Practice Address - Phone:818-208-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist