Provider Demographics
NPI:1801417399
Name:FRICKE, SARAH PATRICIA (LCSWA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:PATRICIA
Last Name:FRICKE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1704
Mailing Address - Country:US
Mailing Address - Phone:336-708-7163
Mailing Address - Fax:
Practice Address - Street 1:155 NORTHPOINT AVE STE 201
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7723
Practice Address - Country:US
Practice Address - Phone:336-907-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0138631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical