Healthcare Provider Details

I. General information

NPI: 1053660118
Provider Name (Legal Business Name): SARAH BURNS MCCARLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 07/28/2021
Certification Date: 07/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10410 PLANK RD
CLINTON LA
70722-3710
US

IV. Provider business mailing address

22601 HWY 190
ROBERT LA
70455-0395
US

V. Phone/Fax

Practice location:
  • Phone: 225-683-5292
  • Fax: 225-683-3411
Mailing address:
  • Phone: 985-542-2466
  • Fax: 985-542-2755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9049
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: