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General NPI Number Information
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NPI Number | 1962221234
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Entity Type | Organization
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Legal Business Name | SAGEWORK SOLUTIONS LLC
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 680 CAMPBELL RD
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City | KESWICK
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State | VA
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Zip | 22947-2113
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Country | US
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Telephone | 434-423-4303
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Fax | 434-302-9676
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Provider Business Mailing Address
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Address Line | 680 CAMPBELL RD
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City | KESWICK
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State | VA
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Zip | 22947-2113
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Country | US
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Telephone | 703-336-2285
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON STEWART ENOLD
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Credential | LCSW
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Telephone | 703-336-2285
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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 |
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License Number State |
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