Healthcare Provider Details

I. General information

NPI: 1699614339
Provider Name (Legal Business Name): MCKENNA SARAC LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SKYE SARAC

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COPPERFIELD BLVD NE STE 105
CONCORD NC
28025-2460
US

IV. Provider business mailing address

9500 GROVE CREST LN APT 522
CHARLOTTE NC
28262-4532
US

V. Phone/Fax

Practice location:
  • Phone: 704-782-3131
  • Fax: 704-782-3131
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP021499
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: