Provider Demographics
NPI:1235707498
Name:SLOOPE, SARA (LCSWA, LCASA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SLOOPE
Suffix:
Gender:F
Credentials:LCSWA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 CABOT DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-6414
Mailing Address - Country:US
Mailing Address - Phone:843-991-8714
Mailing Address - Fax:
Practice Address - Street 1:1920 S 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6611
Practice Address - Country:US
Practice Address - Phone:910-632-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0163022255A2300X, 1041C0700X
NCLCAS-27420101YA0400X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)