Healthcare Provider Details

I. General information

NPI: 1114864568
Provider Name (Legal Business Name): SARAH ELIZABETH EASTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 RED OAKS SHOPPING CTR
RONCEVERTE WV
24970-1364
US

IV. Provider business mailing address

173 AIDAN LN
LEWISBURG WV
24901-9556
US

V. Phone/Fax

Practice location:
  • Phone: 304-520-4240
  • Fax:
Mailing address:
  • Phone: 615-339-6777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: