Provider Demographics
NPI:1225799893
Name:CASEY, SARAH ELIZABETH (MS, NCC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:CASEY
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:CASEY
Other - Last Name:VEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, NCC
Mailing Address - Street 1:4330 S LEE ST STE 600-A
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3072
Mailing Address - Country:US
Mailing Address - Phone:770-648-2500
Mailing Address - Fax:
Practice Address - Street 1:4330 S LEE ST STE 600-A
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3072
Practice Address - Country:US
Practice Address - Phone:770-648-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPENDING101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor