Provider Demographics
NPI:1053752048
Name:TOMCALA, SARAH R (MA, LPC, CADC, LMHC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:TOMCALA
Suffix:
Gender:F
Credentials:MA, LPC, CADC, LMHC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:R
Other - Last Name:VAUGHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, CADC, LMHC
Mailing Address - Street 1:1175 JASON LEE DR
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9029
Mailing Address - Country:US
Mailing Address - Phone:317-370-7310
Mailing Address - Fax:
Practice Address - Street 1:1175 JASON LEE DR
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9029
Practice Address - Country:US
Practice Address - Phone:317-370-7310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MI6401014789101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health