Provider Demographics
NPI:1578812475
Name:SCHALLER, SARAH (MSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-718-4360
Mailing Address - Fax:
Practice Address - Street 1:648 E MONMOUTH ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-3227
Practice Address - Country:US
Practice Address - Phone:336-718-4360
Practice Address - Fax:336-718-4369
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NCC0120701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program