Provider Demographics
NPI:1073646832
Name:PRICE, SARA LEE (LPC, LCAS)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:LEE
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W MILLBROOK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4580
Mailing Address - Country:US
Mailing Address - Phone:919-500-6166
Mailing Address - Fax:180-088-6301
Practice Address - Street 1:203 W MILLBROOK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4580
Practice Address - Country:US
Practice Address - Phone:919-500-6166
Practice Address - Fax:180-088-6301
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC217101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC141KTOtherBCBS
NC6005322Medicaid
NC017PJOtherSERENITY BCBS
NC6102964Medicaid