Healthcare Provider Details

I. General information

NPI: 1083561617
Provider Name (Legal Business Name): SARAH PEVELER NCSP, LPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 9TH ST
DURHAM NC
27705-4104
US

IV. Provider business mailing address

913 9TH ST
DURHAM NC
27705-4104
US

V. Phone/Fax

Practice location:
  • Phone: 919-560-3963
  • Fax:
Mailing address:
  • Phone: 919-560-3963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1056049
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: