Provider Demographics
NPI:1992027288
Name:BURDETTE, SARAH ELIZABETH (CRC,LCAS,LPC)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:BURDETTE
Suffix:
Gender:F
Credentials:CRC,LCAS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 TROY DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7661
Mailing Address - Country:US
Mailing Address - Phone:910-815-3368
Mailing Address - Fax:
Practice Address - Street 1:2520 TROY DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7661
Practice Address - Country:US
Practice Address - Phone:910-815-3368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-27
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1569101YA0400X
NC8003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health