MEDICARE: SARAH GRACE ROMPALO LCSW

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
1	1041C0700X	Clinical Social Worker	C019828	NC

General Provider Information

NPI Number	:	1679265920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH GRACE ROMPALO LCSW

Provider Business Mailing Address
First Line	:	1633 NEW GARDEN RD # 1251
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-2001
Country	:	US
Telephone Number	:	336-439-1941
Fax Number	:

Provider Business Practice Location Address
First Line	:	1633 NEW GARDEN RD # 1251
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-2001
Country	:	US
Telephone Number	:	336-249-0237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2023
Last Update Date	:	05/14/2026

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