1235586827 NPI number — SARAH F. O'BRIEN LCSW LLC

Table of content: (NPI 1235586827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235586827 NPI number — SARAH F. O'BRIEN LCSW LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SARAH F. O'BRIEN LCSW LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235586827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8605 ROLANDO DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENRICO
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23229-5625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-939-7085
Provider Business Mailing Address Fax Number:
804-729-3445

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8401 PATTERSON AVE
Provider Second Line Business Practice Location Address:
G101
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23229-6430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-939-7085
Provider Business Practice Location Address Fax Number:
804-729-3445
Provider Enumeration Date:
05/24/2016

Additional Information

Authorized Official

Authorized Official Last Name:
O'BRIEN
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
E. F.
Authorized Official Title or Position:
OWNER/THERAPIST
Authorized Official Telephone Number:
434-939-7085

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904008615 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1134429400 . This is a "NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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