Healthcare Provider Details

I. General information

NPI: 1760251094
Provider Name (Legal Business Name): SARAH SU LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 E LENOIR ST
RALEIGH NC
27601-2333
US

IV. Provider business mailing address

109 N CHURCH ST
LOUISBURG NC
27549-2528
US

V. Phone/Fax

Practice location:
  • Phone: 919-438-0644
  • Fax:
Mailing address:
  • Phone: 252-477-0008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number20011
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: