Provider Demographics
NPI:1962454496
Name:FOLSOM, SARAH D (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:D
Last Name:FOLSOM
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ARROWWOOD CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-8966
Mailing Address - Country:US
Mailing Address - Phone:919-870-5140
Mailing Address - Fax:888-282-8635
Practice Address - Street 1:22 ARROWWOOD CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-8966
Practice Address - Country:US
Practice Address - Phone:919-870-5140
Practice Address - Fax:888-282-8635
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1003550224Z00000X
NC1124235Z00000X
VA2202004090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7432913Medicaid
NC32913OtherBCBS