Provider Demographics
NPI:1275965576
Name:YATES, SARA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:YATES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 HIGHGATE FAMILY MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713
Mailing Address - Country:US
Mailing Address - Phone:919-361-2644
Mailing Address - Fax:
Practice Address - Street 1:5317 HIGHGATE FAMILY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-361-2644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0098131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP008155OtherNORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD
NCC009813OtherNORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD