Provider Demographics
NPI:1023981164
Name:DESHIELDS, SARAH JANE (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JANE
Last Name:DESHIELDS
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 WILDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4484
Mailing Address - Country:US
Mailing Address - Phone:980-428-4218
Mailing Address - Fax:
Practice Address - Street 1:326 WILDWOOD LN
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4484
Practice Address - Country:US
Practice Address - Phone:980-428-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health