Provider Demographics
NPI:1063633741
Name:SAWYERS, SUSAN L (LPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:SAWYERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 HASTINGS HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-6809
Mailing Address - Country:US
Mailing Address - Phone:336-650-0435
Mailing Address - Fax:
Practice Address - Street 1:HOOTS MEMORIAL HOSPITAL, 624 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055
Practice Address - Country:US
Practice Address - Phone:336-679-6719
Practice Address - Fax:336-679-6723
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3796101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional