Provider Demographics
NPI:1750792065
Name:KOZLOWSKI, SARAH ELIZABETH (MA, LPC, LCASA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:KOZLOWSKI
Suffix:
Gender:F
Credentials:MA, LPC, LCASA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:REAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, LCASA
Mailing Address - Street 1:911 HAY ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5313
Mailing Address - Country:US
Mailing Address - Phone:910-438-0939
Mailing Address - Fax:
Practice Address - Street 1:911 HAY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305
Practice Address - Country:US
Practice Address - Phone:910-438-0939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21153101YA0400X
NC10737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)