Healthcare Provider Details

I. General information

NPI: 1801257654
Provider Name (Legal Business Name): SARA MERIE THIBODEAU SCHULDT LCMHC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 CLAYTON ST
ASHEVILLE NC
28801-2424
US

IV. Provider business mailing address

36 CLAYTON ST
ASHEVILLE NC
28801-2424
US

V. Phone/Fax

Practice location:
  • Phone: 828-620-1291
  • Fax:
Mailing address:
  • Phone: 828-620-1291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11381
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: