=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407021975
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAURYN SAWYER MSW LCSW PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2008
-----------------------------------------------------
Last Update Date | 04/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 223 COMMERCE ST STE D SUITE D
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27858-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-752-1617
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 30834
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27833-0834
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-752-1617
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. LAURYN SAWYER
-----------------------------------------------------
Credential | MSW LCSW PLLC
-----------------------------------------------------
Telephone | 252-752-1617
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | C003454
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------