1407166374 NPI number — MRS. SARA ANNE SPRINGER LMFT

Table of content: MRS. SARA ANNE SPRINGER LMFT (NPI 1407166374)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407166374 NPI number — MRS. SARA ANNE SPRINGER LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPRINGER
Provider First Name:
SARA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
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:
1407166374
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/02/2019
NPI Reactivation Date:
12/22/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 188
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76579-0188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1407 LOWER TROY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76579-2608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-718-7929
Provider Business Practice Location Address Fax Number:
254-718-7929
Provider Enumeration Date:
10/13/2010

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: 106H00000X , with the licence number:  201314 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 162861201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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