MEDICARE: SARA M PHILLIPS

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	1041S0200X	School Social Worker		VA

General Provider Information

NPI Number	:	1326901265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA M PHILLIPS

Provider Business Mailing Address
First Line	:	2100 WASHINGTON BLVD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5703
Country	:	US
Telephone Number	:	571-390-8715
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 WASHINGTON BLVD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5703
Country	:	US
Telephone Number	:	571-390-8715
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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