Healthcare Provider Details

I. General information

NPI: 1306619903
Provider Name (Legal Business Name): MISS SARA PEPKA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 SE MAYNARD RD STE 110
CARY NC
27511-4164
US

IV. Provider business mailing address

545 FOSTER ST UNIT 327
DURHAM NC
27701-2597
US

V. Phone/Fax

Practice location:
  • Phone: 919-377-0184
  • Fax:
Mailing address:
  • Phone: 828-546-9583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023802
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: