Provider Demographics
NPI:1619789765
Name:SARAH BOUDJAKDJI LLC
Entity type:Organization
Organization Name:SARAH BOUDJAKDJI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUDJAKDJI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-842-9582
Mailing Address - Street 1:244 FM 306 # 120-208
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5488
Mailing Address - Country:US
Mailing Address - Phone:715-302-4036
Mailing Address - Fax:
Practice Address - Street 1:211 W MERRIWEATHER STREET
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130
Practice Address - Country:US
Practice Address - Phone:512-842-9582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)