Provider Demographics
NPI:1972062693
Name:HELTON, SARAH NICOLE (MED LPES)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:NICOLE
Last Name:HELTON
Suffix:
Gender:F
Credentials:MED LPES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SUMPTER HILL DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8481
Mailing Address - Country:US
Mailing Address - Phone:423-736-4463
Mailing Address - Fax:
Practice Address - Street 1:7301 RIVERS AVE STE 100
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4650
Practice Address - Country:US
Practice Address - Phone:843-637-4211
Practice Address - Fax:843-793-3691
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4716103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool