Provider Demographics
NPI:1649721911
Name:WHITLEY, SARA REBEKAH (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:REBEKAH
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 135
Mailing Address - Street 2:
Mailing Address - City:BAT CAVE
Mailing Address - State:NC
Mailing Address - Zip Code:28710-0135
Mailing Address - Country:US
Mailing Address - Phone:828-222-7949
Mailing Address - Fax:844-234-7856
Practice Address - Street 1:212 S GROVE ST STE F
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-4006
Practice Address - Country:US
Practice Address - Phone:828-222-7949
Practice Address - Fax:828-234-7856
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC110071041C0700X
NCC0082501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical