Basic Information
| Provider Information | |||||||||
| NPI: | 1023418423 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW-A | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | POLLARD | ||||||||
| OtherFirstName: | SARAH | ||||||||
| OtherMiddleName: | ELIZABETH | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 201 GOVERNMENT AVE SW | ||||||||
| Address2: | HICKORY | ||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286022954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282671740 | ||||||||
| FaxNumber: | 8282671746 | ||||||||
| Practice Location | |||||||||
| Address1: | 315 WILKESBORO BLVD NE | ||||||||
| Address2: | LENOIR | ||||||||
| City: | LENOIR | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286454498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287546087 | ||||||||
| FaxNumber: | 8282671746 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2014 | ||||||||
| LastUpdateDate: | 07/30/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | P008598 | NC | N | Behavioral Health & Social Service Providers | Counselor | Professional | 1041C0700X | P008598 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.