Provider Demographics
NPI:1164853776
Name:RADER, SALLY JANE (LPC, LCAS ,NCC)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:JANE
Last Name:RADER
Suffix:
Gender:F
Credentials:LPC, LCAS ,NCC
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:RADER
Other - Last Name:CURRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LCAS ,NCC
Mailing Address - Street 1:3389 STONES THROW DR
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-8897
Mailing Address - Country:US
Mailing Address - Phone:704-437-1434
Mailing Address - Fax:
Practice Address - Street 1:301 E MEETING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3593
Practice Address - Country:US
Practice Address - Phone:828-437-3000
Practice Address - Fax:828-437-4999
Is Sole Proprietor?:No
Enumeration Date:2013-12-07
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20269101YA0400X
101YP2500X
NC10038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional