Provider Demographics
NPI:1992062723
Name:MCGILL, SARAH LYNN (MS, LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:MCGILL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 W 21ST ST STE 3L
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6915
Mailing Address - Country:US
Mailing Address - Phone:814-490-6431
Mailing Address - Fax:833-231-4272
Practice Address - Street 1:2700 W 21ST ST STE 3L
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-6915
Practice Address - Country:US
Practice Address - Phone:814-580-8882
Practice Address - Fax:833-231-4272
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006279101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC006279OtherLICENSE NUMBER
PA1033695900002Medicaid