1962695817 NPI number — MRS. SARAH LEIGH KING-FINLEY LPC

Table of content: MRS. SARAH LEIGH KING-FINLEY LPC (NPI 1962695817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962695817 NPI number — MRS. SARAH LEIGH KING-FINLEY LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KING-FINLEY
Provider First Name:
SARAH
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962695817
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLARD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65781
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-685-4208
Provider Business Mailing Address Fax Number:
417-685-4238

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 E. JACKON STREET
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
WILLARD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65781
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-685-4208
Provider Business Practice Location Address Fax Number:
417-685-4238
Provider Enumeration Date:
08/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 2004036292 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MO2831178 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 499252500 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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