Provider Demographics
NPI:1861182560
Name:RIDDER, SARAH (MS, NCC, BSL)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RIDDER
Suffix:
Gender:F
Credentials:MS, NCC, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 SICKLER POND RD
Mailing Address - Street 2:
Mailing Address - City:JERMYN
Mailing Address - State:PA
Mailing Address - Zip Code:18433-3623
Mailing Address - Country:US
Mailing Address - Phone:570-351-7221
Mailing Address - Fax:
Practice Address - Street 1:201 LACKAWANNA AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1953
Practice Address - Country:US
Practice Address - Phone:570-766-0772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health