Provider Demographics
NPI:1851130835
Name:DEVRIENDT, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DEVRIENDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 W HONAKER RD
Mailing Address - Street 2:
Mailing Address - City:STAMPING GROUND
Mailing Address - State:KY
Mailing Address - Zip Code:40379-9716
Mailing Address - Country:US
Mailing Address - Phone:859-358-3908
Mailing Address - Fax:
Practice Address - Street 1:137 W HONAKER RD
Practice Address - Street 2:
Practice Address - City:STAMPING GROUND
Practice Address - State:KY
Practice Address - Zip Code:40379-9716
Practice Address - Country:US
Practice Address - Phone:859-358-3908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY273672101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health