Healthcare Provider Details

I. General information

NPI: 1831468156
Provider Name (Legal Business Name): SARA KIRKLAND HUFFMAN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARA KIRKLAND OSBORNE

II. Dates (important events)

Enumeration Date: 12/14/2011
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6602 MADERIA CT
WHITSETT NC
27377
US

IV. Provider business mailing address

6602 MADERIA CT
WHITSETT NC
27377-9138
US

V. Phone/Fax

Practice location:
  • Phone: 336-214-6584
  • Fax:
Mailing address:
  • Phone: 336-214-6584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP005613
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC007956
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: