Healthcare Provider Details

I. General information

NPI: 1306305370
Provider Name (Legal Business Name): SARA JANE BEARD-LINTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 03/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 NASH ST NE
WILSON NC
27893-3045
US

IV. Provider business mailing address

2448 CANNON RD
WINTERVILLE NC
28590-8993
US

V. Phone/Fax

Practice location:
  • Phone: 252-291-2200
  • Fax:
Mailing address:
  • Phone: 252-902-8963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: