Provider Demographics
NPI:1659732261
Name:TALLEY, SARAH SIZEMORE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:SIZEMORE
Last Name:TALLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-4206
Mailing Address - Country:US
Mailing Address - Phone:336-703-3697
Mailing Address - Fax:336-748-3100
Practice Address - Street 1:640 HOLLY AVE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101
Practice Address - Country:US
Practice Address - Phone:336-725-3999
Practice Address - Fax:336-725-7720
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0035691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical