Healthcare Provider Details

I. General information

NPI: 1649184086
Provider Name (Legal Business Name): SARAH REBECCA LAWRENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5970 FAIRVIEW RD STE 600
CHARLOTTE NC
28210-2111
US

IV. Provider business mailing address

1202 COLONIAL DR
ALBEMARLE NC
28001-2953
US

V. Phone/Fax

Practice location:
  • Phone: 910-941-8761
  • Fax: 910-335-8018
Mailing address:
  • Phone: 910-941-8761
  • Fax: 910-335-8018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11052
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23261
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: