Provider Demographics
NPI:1467663807
Name:SARAH S. MIMS, COUNSELING, P.A.
Entity Type:Organization
Organization Name:SARAH S. MIMS, COUNSELING, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:MIMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-350-1033
Mailing Address - Street 1:29 RAVENSCROFT DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3649
Mailing Address - Country:US
Mailing Address - Phone:828-350-1033
Mailing Address - Fax:
Practice Address - Street 1:29 RAVENSCROFT DR
Practice Address - Street 2:SUITE 310
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3649
Practice Address - Country:US
Practice Address - Phone:828-350-1033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0021461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty