Healthcare Provider Details

I. General information

NPI: 1912633280
Provider Name (Legal Business Name): SARAH GRANATO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 FOREST AVE STE 200
RICHMOND VA
23226-3792
US

IV. Provider business mailing address

29311 CARSON RD
CARSON VA
23830-9200
US

V. Phone/Fax

Practice location:
  • Phone: 804-207-6737
  • Fax:
Mailing address:
  • Phone: 757-333-2776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904012563
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: