Provider Demographics
NPI:1699582650
Name:SARAH BUDKE PLLC
Entity type:Organization
Organization Name:SARAH BUDKE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BUDKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-772-3264
Mailing Address - Street 1:2095 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48895-9603
Mailing Address - Country:US
Mailing Address - Phone:810-772-3264
Mailing Address - Fax:
Practice Address - Street 1:2095 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:MI
Practice Address - Zip Code:48895-9603
Practice Address - Country:US
Practice Address - Phone:810-772-3264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1619594975OtherNPI