Provider Demographics
NPI:1952719130
Name:PRIVETTE, SARAH ANNA (MS, LCAS, LPCA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANNA
Last Name:PRIVETTE
Suffix:
Gender:F
Credentials:MS, LCAS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 LYNNDALE CT STE F
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5443
Mailing Address - Country:US
Mailing Address - Phone:252-353-8001
Mailing Address - Fax:252-353-5559
Practice Address - Street 1:600 LYNNDALE CT STE F
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5443
Practice Address - Country:US
Practice Address - Phone:252-353-8001
Practice Address - Fax:252-353-5559
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-20561101YA0400X
NCA11053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)