=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336974930
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH BRITTAIN MCKINNEY MA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/04/2024
-----------------------------------------------------
Last Update Date | 09/04/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5850 FAYETTEVILLE RD STE 211
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27713-6289
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-294-8981
-----------------------------------------------------
Fax | 919-999-2497
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 166 SUMMER CREEK LN
-----------------------------------------------------
City | SANFORD
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27332-6285
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-857-7316
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 20275A
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------