Provider Demographics
NPI:1962520536
Name:SAWYER HORNE, JESSICA SYBIL (CSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SYBIL
Last Name:SAWYER HORNE
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:SYBIL
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:116 S LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3657
Practice Address - Country:US
Practice Address - Phone:910-895-2462
Practice Address - Fax:910-895-9896
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2421101YA0400X
NCC0061881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007037Medicaid
NC6007037Medicaid