Basic Information
Provider Information
NPI: 1427689710
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCDIARMID
FirstName: SARAH
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: BA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 N STATE ST
Address2:  
City: STANTON
State: MI
PostalCode: 488889702
CountryCode: US
TelephoneNumber: 9898317520
FaxNumber: 9898317578
Practice Location
Address1: 611 N STATE ST
Address2:  
City: STANTON
State: MI
PostalCode: 488889702
CountryCode: US
TelephoneNumber: 9898317520
FaxNumber: 9898317578
Other Information
ProviderEnumerationDate: 01/27/2020
LastUpdateDate: 01/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X  Y Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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