Provider Demographics
NPI:1245242668
Name:ROE, SARAH J (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:ROE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 OSTERVILLE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7525
Mailing Address - Country:US
Mailing Address - Phone:919-714-1634
Mailing Address - Fax:919-336-5185
Practice Address - Street 1:106 OSTERVILLE DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7525
Practice Address - Country:US
Practice Address - Phone:919-714-1634
Practice Address - Fax:919-336-5185
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0034861041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty