Healthcare Provider Details

I. General information

NPI: 1407750730
Provider Name (Legal Business Name): SARAH J CLARK LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ARDMORE ST STE 404
BLACKSBURG VA
24060-9922
US

IV. Provider business mailing address

100 ARDMORE ST STE 404
BLACKSBURG VA
24060-9922
US

V. Phone/Fax

Practice location:
  • Phone: 540-709-8966
  • Fax: 540-779-7665
Mailing address:
  • Phone: 540-709-8966
  • Fax: 540-779-7665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: SARAH J CLARK
Title or Position: OWNER
Credential: LCSW
Phone: 540-709-8966