Provider Demographics
NPI:1720250426
Name:PROPST, SARA LOUDERMILK (PHD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LOUDERMILK
Last Name:PROPST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MICHELLE
Other - Last Name:LOUDERMILK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6350 W ANDREW JOHNSON HWY
Mailing Address - Street 2:DEPARTMENT 100
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8605
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:10731 CHAPMAN HWY
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-4765
Practice Address - Country:US
Practice Address - Phone:865-573-0698
Practice Address - Fax:865-573-3174
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3510103TC0700X
TN390200000X
TNP3027103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program