Provider Demographics
NPI:1386486579
Name:SARAH PROEMSEY LICENSED PROFESSIONAL CLINICAL COUNSELOR, INC.
Entity type:Organization
Organization Name:SARAH PROEMSEY LICENSED PROFESSIONAL CLINICAL COUNSELOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PROEMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:650-703-2765
Mailing Address - Street 1:405 PRIMROSE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4091
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:405 PRIMROSE RD STE 208
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4091
Practice Address - Country:US
Practice Address - Phone:650-206-9505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)