Basic Information
| Provider Information | |||||||||
| NPI: | 1164853776 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RADER | ||||||||
| FirstName: | SALLY | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | LPC, LCAS ,NCC | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | CURRIE | ||||||||
| OtherFirstName: | SALLY | ||||||||
| OtherMiddleName: | RADER | ||||||||
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| OtherCredential: | LPC, LCAS ,NCC | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3389 STONES THROW DR | ||||||||
| Address2: | |||||||||
| City: | VALDESE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286908897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044371434 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 301 E MEETING ST | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286553593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284373000 | ||||||||
| FaxNumber: | 8284374999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2013 | ||||||||
| LastUpdateDate: | 09/05/2019 | ||||||||
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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 | 101YA0400X | 20269 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | 10038 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.