Provider Demographics
NPI:1851196745
Name:FORSGREN, SARAH ELIZABETH DEINES
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH DEINES
Last Name:FORSGREN
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 1:1022 N 4TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3100
Mailing Address - Country:US
Mailing Address - Phone:208-457-2909
Mailing Address - Fax:208-450-2239
Practice Address - Street 1:1022 N 4TH ST STE 101
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3100
Practice Address - Country:US
Practice Address - Phone:208-457-2909
Practice Address - Fax:208-450-2239
Is Sole Proprietor?:No
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID9071142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional