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General NPI Number Information
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NPI Number | 1801308424
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Entity Type | Individual
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Provider Name | SARAH ELIZABETH ELLEN LPC
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Gender | Female
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Dates
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Enumeration Date | 11/05/2017
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 411 BROADWAY ST
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City | QUANTICO
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State | VA
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Zip | 22134-3428
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Country | US
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Telephone | 240-921-8566
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Fax | 240-623-9818
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Provider Business Mailing Address
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Address Line | 114 CEDARDEEN CT
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City | CEDAR POINT
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State | NC
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Zip | 28584-8037
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Country | US
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Telephone | 910-209-3732
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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 | 0701007227
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License Number State | VA
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