MEDICARE: DR. SARAH VANLANDINGHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810006373	VA

General Provider Information

NPI Number	:	1184245508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH VANLANDINGHAM

Provider Business Mailing Address
First Line	:	552 FORT EVANS RD STE 206
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20176-3378
Country	:	US
Telephone Number	:	703-777-7755
Fax Number	:

Provider Business Practice Location Address
First Line	:	552 FORT EVANS RD STE 206
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20176-3378
Country	:	US
Telephone Number	:	703-777-7755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2020
Last Update Date	:	05/17/2022

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Directions to “ DR. SARAH VANLANDINGHAM ” Practice Location

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