Individual provider Active NPI

Sarah Fehrenbacher

  • Professional Counselor
  • Lawrenceville, IL
National Provider Identifier
1497151641
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
036105698 Issued in IL
Practice address
11020 State Route 250
Lawrenceville, IL 62439-3379
Phone
(618) 943-3754
Fax
(618) 943-3657
NPI assigned
Nov 17, 2014
Last updated
Nov 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 036105698 IL Primary

Addresses

Primary practice location

11020 State Route 250
Lawrenceville, IL 62439-3379

Mailing address

11020 State Route 250
Lawrenceville, IL 62439-3379
Phone (618) 943-3754

Other identifiers 1

IdentifierTypeStateIssuer
036072942MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
036105698ILMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1497151641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11020 STATE ROUTE 250",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624393379",
            "telephone_number": "618-943-3754",
            "fax_number": "618-943-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 STATE ROUTE 250",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624393379",
            "telephone_number": "618-943-3754",
            "fax_number": "618-943-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEHRENBACHER",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "036105698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072942",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.