Provider Demographics
NPI:1285605584
Name:DEBOIS, SARAH LOUISE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LOUISE
Last Name:DEBOIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:LOUISE
Other - Last Name:STEVENSON-DEBOIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:100 S 1000 W
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-4010
Mailing Address - Country:US
Mailing Address - Phone:435-843-3530
Mailing Address - Fax:435-843-3555
Practice Address - Street 1:100 S 1000 W
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-4010
Practice Address - Country:US
Practice Address - Phone:435-843-3520
Practice Address - Fax:435-843-3555
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT032206235011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT9429383488006OtherU009 - CHAMPUS
UT03220623500001OtherBLUE CROSS
UT683602OtherDESERET MUTUAL
UT942938348SAFOtherEDUCATORS MUTUAL
UT107004148101OtherU006 - INTRMTN HEALTH CAR
UTP38935Medicare UPIN
UT9429383488006OtherU009 - CHAMPUS