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General NPI Number Information
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NPI Number | 1295196376
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Entity Type | Individual
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Provider Name | SARA GREENE MCCAULEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 102 CUSTER RD BUILDING 203
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City | FORT MYER
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State | VA
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Zip | 22211-1228
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Country | US
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Telephone | 703-696-6611
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Fax |
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Provider Business Mailing Address
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Address Line | 904 ROLFE PL
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City | ALEXANDRIA
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State | VA
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Zip | 22314-1384
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Country | US
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Telephone | 520-780-9901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-13653
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50080457
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License Number State | DC
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