Provider Demographics
NPI:1316303712
Name:WILLIAMS, SARAH JOHNSON (MA/EDS, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JOHNSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA/EDS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-4025
Mailing Address - Country:US
Mailing Address - Phone:704-682-1277
Mailing Address - Fax:
Practice Address - Street 1:196 OLD STAGECOACH LN
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625
Practice Address - Country:US
Practice Address - Phone:704-764-1462
Practice Address - Fax:704-765-9645
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health