Provider Demographics
NPI:1124490396
Name:DRAKE, SARAH M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:M
Last Name:DRAKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4206 FOX TRL
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-3415
Mailing Address - Country:US
Mailing Address - Phone:254-717-1238
Mailing Address - Fax:
Practice Address - Street 1:80 MORGANS POINT RD STE 105
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-6886
Practice Address - Country:US
Practice Address - Phone:254-831-3029
Practice Address - Fax:254-939-3996
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX540581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX409274401Medicaid