Healthcare Provider Details

I. General information

NPI: 1144158874
Provider Name (Legal Business Name): MS. SARAH BRUSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1987 S MILITARY HWY
CHESAPEAKE VA
23320-4462
US

IV. Provider business mailing address

103 LISBON CT APT 101
VIRGINIA BEACH VA
23462-3184
US

V. Phone/Fax

Practice location:
  • Phone: 757-472-4088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04433
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: