Provider Demographics
NPI:1932650553
Name:WALTER, SARA (PHD, LPCA)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:WALTER
Suffix:
Gender:F
Credentials:PHD, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 E ACADEMY ST STE 205
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2382
Mailing Address - Country:US
Mailing Address - Phone:914-263-0059
Mailing Address - Fax:
Practice Address - Street 1:602 E ACADEMY ST STE 205
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2382
Practice Address - Country:US
Practice Address - Phone:914-263-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11603101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional