Healthcare Provider Details

I. General information

NPI: 1285061739
Provider Name (Legal Business Name): SARA CHRISTINE DUCKERY L.I.C.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8248 FORT HUNT ROAD
ALEXANDRIA VA
22308
US

IV. Provider business mailing address

8248 FORT HUNT ROAD
ALEXANDRIA VA
22308
US

V. Phone/Fax

Practice location:
  • Phone: 703-799-6175
  • Fax:
Mailing address:
  • Phone: 703-799-6175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberPPS-0607882
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50079129
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904010911
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: