Healthcare Provider Details

I. General information

NPI: 1821230350
Provider Name (Legal Business Name): SARAH M TAYLOR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 FIRE TOWER DR
ROUGEMONT NC
27572-6816
US

IV. Provider business mailing address

515 FIRE TOWER DR
ROUGEMONT NC
27572-6816
US

V. Phone/Fax

Practice location:
  • Phone: 336-512-0702
  • Fax:
Mailing address:
  • Phone: 336-675-2415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006337
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: