Provider Demographics
NPI:1386086403
Name:GONZALEZ, SARAH (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:GONZALEZ
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 1:2970 E LAKE LANSING RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-7415
Mailing Address - Country:US
Mailing Address - Phone:517-230-5695
Mailing Address - Fax:855-978-1293
Practice Address - Street 1:2970 E LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-7415
Practice Address - Country:US
Practice Address - Phone:517-230-5695
Practice Address - Fax:855-978-1293
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006926106H00000X
RIMFT00156106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist