Provider Demographics
NPI:1104505056
Name:AL-ZADJALI, SARAH MOHAMED (MA, LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MOHAMED
Last Name:AL-ZADJALI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10816 ARNETT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7114
Mailing Address - Country:US
Mailing Address - Phone:314-717-9251
Mailing Address - Fax:
Practice Address - Street 1:967 GARDENVIEW OFFICE PKWY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-5917
Practice Address - Country:US
Practice Address - Phone:314-561-9757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020036302101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health