Healthcare Provider Details
I. General information
NPI: 1295376234
Provider Name (Legal Business Name): SARAH BURNS COUNSELING AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/01/2019
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5311 ABNER LN
CHARLOTTE NC
28269-5707
US
IV. Provider business mailing address
5311 ABNER LN
CHARLOTTE NC
28269-5707
US
V. Phone/Fax
- Phone: 980-338-0358
- Fax:
- Phone: 980-338-0358
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
BURNS
Title or Position: THERAPIST
Credential: LPC
Phone: 980-338-0358