Provider Demographics
NPI:1861992802
Name:HOLTCAMP, SARAH (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:HOLTCAMP
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 1:1907 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:HIGGINSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64037-1445
Mailing Address - Country:US
Mailing Address - Phone:816-813-7440
Mailing Address - Fax:
Practice Address - Street 1:1907 WILLOW ST
Practice Address - Street 2:
Practice Address - City:HIGGINSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64037-1445
Practice Address - Country:US
Practice Address - Phone:816-813-7440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10495104100000X
MO2017028791104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker