Basic Information
| Provider Information | |||||||||
| NPI: | 1255096020 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDERMOTT | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | MCDERMOTT | ||||||||
| OtherFirstName: | SALLY | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2262 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | LEMONT FURNACE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154561332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243238200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3591 PITTSBURGH RD | ||||||||
| Address2: | |||||||||
| City: | PERRYOPOLIS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154731307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247368390 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2021 | ||||||||
| LastUpdateDate: | 11/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.