Healthcare Provider Details

I. General information

NPI: 1932022084
Provider Name (Legal Business Name): SARAH NOELLE BOTTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OLD LYNCHBURG RD
CHARLOTTESVILLE VA
22903-6550
US

IV. Provider business mailing address

116 S JACKSON AVE
WAYNESBORO VA
22980-5934
US

V. Phone/Fax

Practice location:
  • Phone: 434-972-1800
  • Fax:
Mailing address:
  • Phone: 775-686-8041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020597
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: