Provider Demographics
NPI:1447785134
Name:NATHANIEL DAVID SAWYER
Entity type:Organization
Organization Name:NATHANIEL DAVID SAWYER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNSELING
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFTA
Authorized Official - Phone:423-650-9528
Mailing Address - Street 1:4 ROUND SPRING LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-8965
Mailing Address - Country:US
Mailing Address - Phone:423-650-9528
Mailing Address - Fax:
Practice Address - Street 1:5731 N ROXBORO RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-1427
Practice Address - Country:US
Practice Address - Phone:919-627-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11021A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health