Healthcare Provider Details

I. General information

NPI: 1255003125
Provider Name (Legal Business Name): JULIA ELISE SANDERS LCSW, LICSW, LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3190 FAIRVIEW PARK DR SUITE 200 OFFICE #6
FALLS CHURCH VA
22042
US

IV. Provider business mailing address

8401 MAYLAND DR STE A
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 315-456-9551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number099921
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017077
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200004928
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28972
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: