Provider Demographics
NPI:1730797481
Name:MATHERLY, SARA MCGRATH (PHD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MCGRATH
Last Name:MATHERLY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:306 WINDY PEAK LOOP
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1882
Mailing Address - Country:US
Mailing Address - Phone:919-630-2179
Mailing Address - Fax:
Practice Address - Street 1:100 RENEE LYNN CT
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-6511
Practice Address - Country:US
Practice Address - Phone:919-966-5156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist