Provider Demographics
NPI:1285944140
Name:PRECHTEL, SARAH GRACE (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:PRECHTEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:GRACE
Other - Last Name:LOGRASSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3165 MCKELVEY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2550
Mailing Address - Country:US
Mailing Address - Phone:314-206-1614
Mailing Address - Fax:314-206-3399
Practice Address - Street 1:3165 MCKELVEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2550
Practice Address - Country:US
Practice Address - Phone:314-200-6463
Practice Address - Fax:314-206-3992
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 1041C0700X
MO2011002792171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical