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General NPI Number Information
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NPI Number | 1578892204
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Entity Type | Individual
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Provider Name | SANDRA T. HALSEY LCSW, CSOTP
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Gender | Female
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 610 CAMPUS DR
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City | ABINGDON
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State | VA
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Zip | 24210-2589
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Country | US
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Telephone | 276-525-1586
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Fax | 276-525-1609
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Provider Business Mailing Address
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Address Line | 610 CAMPUS DR
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City | ABINGDON
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State | VA
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Zip | 24210-2589
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Country | US
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Telephone | 276-525-1586
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Fax | 276-525-1609
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0812000173
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License Number State | VA
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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 | 0904004398
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License Number State | VA
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