Provider Demographics
NPI:1154806370
Name:CLANTON, SARAH BAUCOM (MA, LPC-A)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BAUCOM
Last Name:CLANTON
Suffix:
Gender:F
Credentials:MA, LPC-A
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:BAUCOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC-A
Mailing Address - Street 1:3954 RED DOC RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-7900
Mailing Address - Country:US
Mailing Address - Phone:704-475-2514
Mailing Address - Fax:
Practice Address - Street 1:3954 RED DOC RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-7900
Practice Address - Country:US
Practice Address - Phone:704-475-2514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health