Provider Demographics
NPI:1255665477
Name:KIRLIK, SARAH BRINLEY (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BRINLEY
Last Name:KIRLIK
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2121 TW ALEXANDER DR STE 124
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6815
Mailing Address - Country:US
Mailing Address - Phone:919-704-1017
Mailing Address - Fax:919-384-5616
Practice Address - Street 1:1127 SURVEYOR DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-4878
Practice Address - Country:US
Practice Address - Phone:919-704-1017
Practice Address - Fax:919-384-5616
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040168391041C0700X
NCC0064091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007408Medicaid