| Doctor Name: | SARA CHARLES GOGUEN |
| NPI Number: | 1003173659 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW |
| License Number: | C007672 |
| Business Practice Address: | 2125 Southend Dr Suite 452 Charlotte, NC - 282035301 |
| Business Phone Number: | 7043781390 |
| Business Fax Number: | 7043781392 |
| Mailing Address: | 7702 Surreywood Pl, CHARLOTTE |
| State: | NC |
| Postal Code: | 282702157 |
| Phone Number: | 7043781390 |
| Fax Number: | 7043781392 |
| NPI Enumeration Date: | 04/20/2012 |
| NPI Last Update Date: | 06/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C007672 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |