MEDICARE: SARA MICHELLE NAMI ATR-BC L-CAT LCAS-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	26607	NC

General Provider Information

NPI Number	:	1295464113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA MICHELLE NAMI ATR-BC L-CAT LCAS-A

Provider Business Mailing Address
First Line	:	4 TRUMAN RD
Second Line	:
City	:	HAVELOCK
State	:	NC
Zip	:	28532-3624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3402 TRENT RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2232
Country	:	US
Telephone Number	:	252-658-0565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	06/07/2022

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