Provider Demographics
NPI:1679912182
Name:SKINNER, SARA KATHLEEN (LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:KATHLEEN
Last Name:SKINNER
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 1:1121 W CHAPEL HILL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3027
Mailing Address - Country:US
Mailing Address - Phone:919-385-0780
Mailing Address - Fax:919-419-9353
Practice Address - Street 1:1121 W CHAPEL HILL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3027
Practice Address - Country:US
Practice Address - Phone:919-385-0780
Practice Address - Fax:919-419-9353
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0095491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical