Provider Demographics
NPI:1851550461
Name:TISON, SARAH-ELIZABETH HAMPSHIRE (MA)
Entity Type:Individual
Prefix:MS
First Name:SARAH-ELIZABETH
Middle Name:HAMPSHIRE
Last Name:TISON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 FARROW DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-7761
Mailing Address - Country:US
Mailing Address - Phone:980-298-3599
Mailing Address - Fax:704-714-1182
Practice Address - Street 1:515 CLANTON RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-1309
Practice Address - Country:US
Practice Address - Phone:704-332-9001
Practice Address - Fax:704-714-1182
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6633101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional