Healthcare Provider Details
I. General information
NPI: 1437599412
Provider Name (Legal Business Name): SARAH KNIGHT UNDERDUE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/05/2013
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
31 SAMFORD ST
ALBERTA VA
23821-2326
US
IV. Provider business mailing address
31 SAMFORD ST
ALBERTA VA
23821-2326
US
V. Phone/Fax
- Phone: 804-835-3089
- Fax:
- Phone: 804-835-3089
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 0701005486 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: