Provider Demographics
NPI:1982990941
Name:BOLME, SARAH (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BOLME
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 NETHERHALL DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-8405
Mailing Address - Country:US
Mailing Address - Phone:704-773-1638
Mailing Address - Fax:704-717-2928
Practice Address - Street 1:608 MCCOMBS AVE
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-3605
Practice Address - Country:US
Practice Address - Phone:704-933-0007
Practice Address - Fax:704-993-0300
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0065991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical