Provider Demographics
NPI:1073764650
Name:OAK CITY COUNSELING
Entity Type:Organization
Organization Name:OAK CITY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OUTPATIENT THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:THATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LCSW
Authorized Official - Phone:919-271-1143
Mailing Address - Street 1:136 MINE LAKE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6417
Mailing Address - Country:US
Mailing Address - Phone:919-271-1143
Mailing Address - Fax:
Practice Address - Street 1:10830 GREATER HILLS ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8653
Practice Address - Country:US
Practice Address - Phone:919-271-1143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0051031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106019Medicaid
NC2852740Medicare PIN