Basic Information
| Provider Information | |||||||||
| NPI: | 1346484391 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEVANEY | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | ROCHELLE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1439 LAZY CREEK CT NE | ||||||||
| Address2: | |||||||||
| City: | KEIZER | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973037805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415541567 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5125 SKYLINE RD S | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973069427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035885993 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2009 | ||||||||
| LastUpdateDate: | 12/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | L4600 | OR | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.