Provider Demographics
NPI:1104309731
Name:UTLEY, SARAH JONELL (LCSWA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JONELL
Last Name:UTLEY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 AMELIA STATION WAY APT 207
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-9631
Mailing Address - Country:US
Mailing Address - Phone:910-303-0071
Mailing Address - Fax:
Practice Address - Street 1:1002 AMELIA STATION WAY APT 207
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-9631
Practice Address - Country:US
Practice Address - Phone:910-303-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-26312101YA0400X
NCC0133151041C0700X
NCP0124751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)