Healthcare Provider Details

I. General information

NPI: 1912299637
Provider Name (Legal Business Name): SANDRA L MASSEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2011
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S MONROE AVE
COVINGTON VA
24426-1635
US

IV. Provider business mailing address

205 E HAWTHORNE ST
COVINGTON VA
24426-1620
US

V. Phone/Fax

Practice location:
  • Phone: 540-965-2100
  • Fax: 540-965-2105
Mailing address:
  • Phone: 540-965-2135
  • Fax: 540-965-6371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701006040
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: