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NPI Code Detail

MEDICARE: SARAH ELIZABETH SMEAD ED.S., LPA

MEDICARE: SARAH ELIZABETH SMEAD ED.S., LPA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist4190736AZ
2103T00000XPsychologist4899NC

General Provider Information

NPI Number : 1508175142
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ELIZABETH SMEAD ED.S., LPA
Provider Business Mailing Address
First Line : 415 ANNABERG LN
Second Line :
City : MONROE
State : NC
Zip : 28110-8655
Country : US
Telephone Number : 859-539-1648
Fax Number :
Provider Business Practice Location Address
First Line : 360 N CASWELL RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-2442
Country : US
Telephone Number : 704-765-2549
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2010
Last Update Date : 08/25/2023

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