Healthcare Provider Details

I. General information

NPI: 1710806542
Provider Name (Legal Business Name): SADORA PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3016 THOROUGHFARE RD
GOLDSBORO NC
27534-7728
US

IV. Provider business mailing address

PO BOX 10231
GOLDSBORO NC
27532-0231
US

V. Phone/Fax

Practice location:
  • Phone: 919-394-9495
  • Fax:
Mailing address:
  • Phone: 919-394-9495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: