Individual provider Active NPI

Sarah Marshall, LCSW, LCAS

  • Clinical Social Worker
  • Clemmons, NC
National Provider Identifier
1477967503
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C010317 Issued in NC
Practice address
2554 Lewisville Clemmons Rd Ste 303
Clemmons, NC 27012-8749
Phone
(336) 429-0254
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 20925 NC
Clinical Social Worker 1041C0700X C010317 NC Primary

Addresses

Primary practice location

2554 Lewisville Clemmons Rd Ste 303
Clemmons, NC 27012-8749

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 564-4950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20925NCMDAddiction (Substance Use Disorder) Counselor
C010317NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1477967503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-564-4950",
            "fax_number": "336-564-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 LEWISVILLE CLEMMONS RD STE 303",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128749",
            "telephone_number": "336-429-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "SARAH",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "20925",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.