MEDICARE: MRS. TESSIE SMITH SADLER LCSW

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	1041C0700X	Clinical Social Worker	0904006071	VA

General Provider Information

NPI Number	:	1184792384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TESSIE SMITH SADLER LCSW

Provider Business Mailing Address
First Line	:	PO BOX 662
Second Line	:
City	:	SOUTH HILL
State	:	VA
Zip	:	23970-0662
Country	:	US
Telephone Number	:	434-774-7559
Fax Number	:	434-774-7559

Provider Business Practice Location Address
First Line	:	306 E ATLANTIC ST
Second Line	:
City	:	SOUTH HILL
State	:	VA
Zip	:	23970-2006
Country	:	US
Telephone Number	:	434-774-7559
Fax Number	:	434-774-7559

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	10/06/2025

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