Provider Demographics
NPI:1104136118
Name:JOGLAR, SARA GAIL (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:GAIL
Last Name:JOGLAR
Suffix:
Gender:
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:GAIL
Other - Last Name:LEAVITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3065 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-3737
Mailing Address - Country:US
Mailing Address - Phone:801-645-5081
Mailing Address - Fax:
Practice Address - Street 1:4645 MIDLAND DR STE 2
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:UT
Practice Address - Zip Code:84401-6825
Practice Address - Country:US
Practice Address - Phone:801-332-9139
Practice Address - Fax:385-855-2132
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT372188-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty