Provider Demographics
NPI:1295102002
Name:VAVRECK, SARAH (MASTERS OF COUNSELIN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:VAVRECK
Suffix:
Gender:F
Credentials:MASTERS OF COUNSELIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W END BLVD
Mailing Address - Street 2:1
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2657
Mailing Address - Country:US
Mailing Address - Phone:717-538-3954
Mailing Address - Fax:336-712-4420
Practice Address - Street 1:1025 W END BLVD
Practice Address - Street 2:1
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2657
Practice Address - Country:US
Practice Address - Phone:717-538-3954
Practice Address - Fax:336-712-4420
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9884101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor