Provider Demographics
NPI:1215084173
Name:WEBB-VANDERPOORTEN, SARAI CHRISTIAN (LMFT)
Entity type:Individual
Prefix:MS
First Name:SARAI
Middle Name:CHRISTIAN
Last Name:WEBB-VANDERPOORTEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 24TH PL
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-1686
Mailing Address - Country:US
Mailing Address - Phone:601-696-6736
Mailing Address - Fax:601-696-6778
Practice Address - Street 1:4715 24TH PL
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-1686
Practice Address - Country:US
Practice Address - Phone:601-696-6736
Practice Address - Fax:601-696-6778
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-0027106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS579697OtherVALUE OPTIONS
MS611657600OtherU.S. DEPT. OF LABOR
MS74312880OtherSEDGWICK
MS$$$$$$$$$OtherMAGELLAN BEHAVIORAL HEALT
MS579697OtherVALUE OPTIONS
MS74312880OtherSEDGWICK