Individual
SARAH LACKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 29TH AVE SW, ALBANY, OR 97321-3416
(541) 926-4828
(541) 926-4891
Mailing address
43350 E BILYEU CREEK DR, SCIO, OR 97374-9335
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
OR
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M7386
OBLSW
OR
Enumeration date
02/20/2018
Last updated
02/13/2020
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