MEDICARE: SARAH MCLILLARD LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904007656	VA

General Provider Information

NPI Number	:	1902277452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MCLILLARD LCSW

Provider Business Mailing Address
First Line	:	5408 CHAMBERLAYNE RD
Second Line	:	SUITE 202
City	:	RICHMOND
State	:	VA
Zip	:	23227-2407
Country	:	US
Telephone Number	:	804-272-2000
Fax Number	:	804-272-2030

Provider Business Practice Location Address
First Line	:	2002 BREMO RD
Second Line	:	SUITE 202
City	:	RICHMOND
State	:	VA
Zip	:	23226-2400
Country	:	US
Telephone Number	:	540-220-4820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2015
Last Update Date	:	01/23/2017

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