MEDICARE: MS. SARA THATCHER MSW, 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	C005103	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1424E	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750329397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARA THATCHER MSW, LCSW

Provider Business Mailing Address
First Line	:	10830 GREATER HILLS ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614-8653
Country	:	US
Telephone Number	:	919-271-1143
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 MINE LAKE CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-6417
Country	:	US
Telephone Number	:	919-271-1143
Fax Number	:

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

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	07/04/2016

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