Provider Demographics
NPI:1659955169
Name:VANDERPOOL, SARAH (LCMHC, NCC, LPSC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:VANDERPOOL
Suffix:
Gender:F
Credentials:LCMHC, NCC, LPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 WESTGATE CENTER DR STE L1
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3106
Mailing Address - Country:US
Mailing Address - Phone:336-448-4451
Mailing Address - Fax:
Practice Address - Street 1:1365 WESTGATE CENTER DR STE L1
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3106
Practice Address - Country:US
Practice Address - Phone:336-448-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16522101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health