Provider Demographics
NPI:1972978336
Name:EILERTSON, SARAH MAY (LPC, MS, NCC, CCTP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MAY
Last Name:EILERTSON
Suffix:
Gender:F
Credentials:LPC, MS, NCC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6773
Mailing Address - Country:US
Mailing Address - Phone:541-500-7111
Mailing Address - Fax:541-507-9118
Practice Address - Street 1:810 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6773
Practice Address - Country:US
Practice Address - Phone:541-500-7111
Practice Address - Fax:541-507-9118
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4352101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health