Provider Demographics
NPI:1053081323
Name:BETZE, SARA (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BETZE
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA BCBA LBA
Mailing Address - Street 1:8521 SIX FORKS RD STE 350N
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5278
Mailing Address - Country:US
Mailing Address - Phone:919-325-0952
Mailing Address - Fax:800-349-8941
Practice Address - Street 1:8521 SIX FORKS RD STE 350
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5863
Practice Address - Country:US
Practice Address - Phone:919-325-0952
Practice Address - Fax:800-349-8941
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC807103K00000X
GA1-23-63761103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty