Individual provider Active NPI

Sara Lynn Jablonski, LPCA

  • Mental Health Counselor
  • Burgaw, NC
National Provider Identifier
1942545272
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A9640 Issued in NC
Practice address
803 S Walker St
Burgaw, NC 28425-5001
Phone
(910) 259-0668
Fax
(910) 259-4526
NPI assigned
Nov 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A9640 NC Primary

Addresses

Primary practice location

803 S Walker St
Burgaw, NC 28425-5001

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 202-5709

Other practice location 1

4701 Wrightsville Ave Ste F1
Wilmington, NC 28403-0020
Phone (910) 616-5144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315000713 NC Practitioner - Mental Health Counselor 0547606345 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A9640NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Horizons Center, Inc. CurrentSince Jan 31, 2024 Accepting new patients
Coastal Horizons Center, Inc. Current Accepting new patients
Coastal Horizons Center Inc CurrentSince Jan 31, 2024 Accepting new patients

Locations

309 Progress Dr
Burgaw, NC 28425
Phone (910) 259-0445

120 Coastal Horizons Dr
Shallotte, NC 28470
Phone (910) 754-4515

615 Shipyard Blvd
Wilmington, NC 28412
Phone (910) 202-5709

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1942545272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-202-5709",
            "fax_number": "910-202-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 S WALKER ST",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284255001",
            "telephone_number": "910-259-0668",
            "fax_number": "910-259-4526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 Wrightsville Ave Ste F1",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284030020",
            "country_code": "US",
            "telephone_number": "910-616-5144",
            "fax_number": "910-392-5629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JABLONSKI",
        "first_name": "SARA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A9640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burgaw, NC

Sources for this page

Verify at the official NPI Registry.