Healthcare Provider Details

I. General information

NPI: 1467133983
Provider Name (Legal Business Name): SARAH ESPINOSA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 CANNONBALL CIR
HAMPTON VA
23669-2400
US

IV. Provider business mailing address

33 CANNONBALL CIR
HAMPTON VA
23669-2400
US

V. Phone/Fax

Practice location:
  • Phone: 845-665-3438
  • Fax:
Mailing address:
  • Phone: 845-665-3438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904018431
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: