Provider Demographics
NPI:1659561264
Name:CARAWAN, SANDRA KAY (MS LMFT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:KAY
Last Name:CARAWAN
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035A DIRECTOR CT
Mailing Address - Street 2:SOUTH CHARLES PROFESSIONAL PARK
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5996
Mailing Address - Country:US
Mailing Address - Phone:252-714-1418
Mailing Address - Fax:252-321-4946
Practice Address - Street 1:1035A DIRECTOR CT
Practice Address - Street 2:SOUTH CHARLES PROFESSIONAL PARK
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5996
Practice Address - Country:US
Practice Address - Phone:252-714-1418
Practice Address - Fax:252-321-4946
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1187106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105240Medicaid