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General NPI Number Information
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NPI Number | 1073788220
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Entity Type | Individual
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Provider Name | SARAH KATHERINE TILLER LCSW, LCAS
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Gender | Female
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 5509 CREEDMOOR RD
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City | RALEIGH
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State | NC
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Zip | 27612-6312
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Country | US
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Telephone | 919-573-6531
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Fax |
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Provider Business Mailing Address
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Address Line | 3216 JOBS JOURNEY CT APT 101
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City | RALEIGH
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State | NC
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Zip | 27610-6655
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Country | US
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Telephone | 919-518-6957
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C005810
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-24439
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License Number State | NC
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