Provider Demographics
NPI:1386702793
Name:KLINZMAN, SARA D (MA, LMHC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:D
Last Name:KLINZMAN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 5TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1801
Mailing Address - Country:US
Mailing Address - Phone:360-350-2888
Mailing Address - Fax:360-943-1769
Practice Address - Street 1:1713 5TH AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1801
Practice Address - Country:US
Practice Address - Phone:360-350-2888
Practice Address - Fax:360-943-1769
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009305101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health