Healthcare Provider Details

I. General information

NPI: 1215476007
Provider Name (Legal Business Name): SARAH AUSTIN SHELTON LCSW, LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 COUNTRY CLUB RD
MOUNT AIRY NC
27030-2347
US

IV. Provider business mailing address

PO BOX 23321
NEW YORK NY
10087-4321
US

V. Phone/Fax

Practice location:
  • Phone: 843-876-1344
  • Fax: 843-876-1347
Mailing address:
  • Phone: 843-876-1344
  • Fax: 843-876-1347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18965
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP015112
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: