Provider Demographics
NPI:1558929125
Name:HENNINGER, SARAH NICOLE (LMSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLE
Last Name:HENNINGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S MILLER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48609-5161
Mailing Address - Country:US
Mailing Address - Phone:989-833-9234
Mailing Address - Fax:989-607-1982
Practice Address - Street 1:105 S MILLER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48609-5161
Practice Address - Country:US
Practice Address - Phone:989-833-9234
Practice Address - Fax:989-607-1982
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801104604104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker