Healthcare Provider Details

I. General information

NPI: 1396574018
Provider Name (Legal Business Name): SARA GUERRY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 BRAEBURN DR
SALEM VA
24153-7302
US

IV. Provider business mailing address

1932 BRAEBURN DR
SALEM VA
24153-7302
US

V. Phone/Fax

Practice location:
  • Phone: 540-358-1519
  • Fax:
Mailing address:
  • Phone: 540-358-1519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904016975
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: