Provider Demographics
NPI:1194274191
Name:WHALEN, SARAH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:WHALEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1971
Mailing Address - Country:US
Mailing Address - Phone:610-420-8099
Mailing Address - Fax:
Practice Address - Street 1:121 N WAYNE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3542
Practice Address - Country:US
Practice Address - Phone:484-253-6910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018134103T00000X
PA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool