Provider Demographics
NPI:1972743292
Name:SCHOLL, SARA JO (LPC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JO
Last Name:SCHOLL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:PAYNE
Other - Last Name:SCHOLL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:41630 WOODRING DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5219
Mailing Address - Country:US
Mailing Address - Phone:586-943-6263
Mailing Address - Fax:586-416-1243
Practice Address - Street 1:18557 CANAL ROAD
Practice Address - Street 2:4
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5219
Practice Address - Country:US
Practice Address - Phone:686-943-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006174101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional