Provider Demographics
NPI:1346002201
Name:QUILL, SARAH (CADCII, CPS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:QUILL
Suffix:
Gender:F
Credentials:CADCII, CPS
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 OAKVIEW PSGE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-1801
Mailing Address - Country:US
Mailing Address - Phone:508-818-3612
Mailing Address - Fax:
Practice Address - Street 1:2563 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-1715
Practice Address - Country:US
Practice Address - Phone:404-699-7774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)