Provider Demographics
NPI:1083164115
Name:JALBERT, SARA (LPC, LP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:JALBERT
Suffix:
Gender:
Credentials:LPC, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 DUNROBIN LN
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-1712
Mailing Address - Country:US
Mailing Address - Phone:203-565-3422
Mailing Address - Fax:
Practice Address - Street 1:27 SIEMON COMPANY DR
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2654
Practice Address - Country:US
Practice Address - Phone:475-222-3886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CT5011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional