Provider Demographics
NPI:1588220891
Name:PASSEY, SARA STUTZNEGGER (LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:STUTZNEGGER
Last Name:PASSEY
Suffix:
Gender:F
Credentials:LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 BEXLEY HILLS BND
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-1887
Mailing Address - Country:US
Mailing Address - Phone:919-244-4722
Mailing Address - Fax:
Practice Address - Street 1:1140 KILDAIRE FARM RD STE 206-5
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4562
Practice Address - Country:US
Practice Address - Phone:919-244-4722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14820106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist