Provider Demographics
NPI:1679750475
Name:FLEEHART, SARA (MS, LMFTA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FLEEHART
Suffix:
Gender:F
Credentials:MS, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11704
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-5704
Mailing Address - Country:US
Mailing Address - Phone:206-780-7782
Mailing Address - Fax:206-780-1964
Practice Address - Street 1:11290 SUNRISE DR NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1353
Practice Address - Country:US
Practice Address - Phone:206-780-7782
Practice Address - Fax:206-780-1964
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG 60115036106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist