MEDICARE: MS. SARAH FRANCES EGGLESTON 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	0904002692	VA

General Provider Information

NPI Number	:	1205950987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARAH FRANCES EGGLESTON LCSW

Provider Business Mailing Address
First Line	:	500 N WASHINGTON ST
Second Line	:	SUITE 101
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-3514
Country	:	US
Telephone Number	:	703-532-4504
Fax Number	:	703-536-1770

Provider Business Practice Location Address
First Line	:	500 N WASHINGTON ST
Second Line	:	SUITE 101
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-3514
Country	:	US
Telephone Number	:	703-532-4504
Fax Number	:	703-536-1770

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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