Healthcare Provider Details

I. General information

NPI: 1063716546
Provider Name (Legal Business Name): SARA H MARLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FINCASTLE DR
BLACKSBURG VA
24060-5036
US

IV. Provider business mailing address

300 FINCASTLE DR
BLACKSBURG VA
24060-5036
US

V. Phone/Fax

Practice location:
  • Phone: 303-903-7862
  • Fax:
Mailing address:
  • Phone: 303-903-7862
  • Fax: 720-398-3157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number992577
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: