Provider Demographics
NPI:1356024145
Name:POOLE, SARAH HOLLOWAY (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:HOLLOWAY
Last Name:POOLE
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2321
Mailing Address - Country:US
Mailing Address - Phone:336-902-2747
Mailing Address - Fax:
Practice Address - Street 1:14072 ELKIN HIGHWAY 268
Practice Address - Street 2:
Practice Address - City:RONDA
Practice Address - State:NC
Practice Address - Zip Code:28670-9199
Practice Address - Country:US
Practice Address - Phone:336-827-0089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0194971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical