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General NPI Number Information
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NPI Number | 1598462392
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Entity Type | Individual
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Provider Name | SAGEN LYNAE BLACKWELL PHD LPC
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Gender | Female
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 3959 ELECTRIC RD STE 425
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City | CAVE SPRING
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State | VA
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Zip | 24018-4563
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Country | US
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Telephone | 540-206-2385
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Fax |
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Provider Business Mailing Address
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Address Line | 4767 WESTVALE RD NE
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City | ROANOKE
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State | VA
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Zip | 24019-5873
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Country | US
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Telephone | 864-706-6710
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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