Provider Demographics
NPI:1548270234
Name:WILLIAMS, SARAH A (PSYD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ASHLAND DR STE 301
Mailing Address - Street 2:P.O. BOX 1447
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7097
Mailing Address - Country:US
Mailing Address - Phone:606-326-0322
Mailing Address - Fax:606-326-9809
Practice Address - Street 1:1000 ASHLAND DR STE 301
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7097
Practice Address - Country:US
Practice Address - Phone:606-326-0322
Practice Address - Fax:606-326-9809
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY130238103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2049036Medicaid
260003492OtherRAILROAD MEDICARE
KY89540048Medicaid
311282299-00OtherBUREAU OF WORKERS COMP
000000050357OtherANTHEM 12 DIGIT
OH2049036Medicaid