Provider Demographics
NPI:1386060960
Name:BOYCHAK, SARA (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BOYCHAK
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LYNN
Other - Last Name:LAUGHTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:411 ANDREWS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2993
Mailing Address - Country:US
Mailing Address - Phone:919-682-5777
Mailing Address - Fax:
Practice Address - Street 1:411 ANDREWS RD STE 130
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2993
Practice Address - Country:US
Practice Address - Phone:919-682-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0092251041C0700X
WASC 604820751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical