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NPI Code Detail

MEDICARE: SANDRA S QUARLES LCSW

MEDICARE:   SANDRA S QUARLES  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
11041C0700XClinical Social Worker0904000159VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2081144MOTHERVASENTARA
3CO3533OTHERVAMCR GROUP
4174570OTHERVAANTHEM
5174570OTHERVAHKP
6004945395OTHERVAVA PREMIER

General Provider Information

NPI Number : 1538243241
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA S QUARLES LCSW
Provider Business Mailing Address
First Line : 221A 63RD ST
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-2124
Country : US
Telephone Number : 757-270-9170
Fax Number :
Provider Business Practice Location Address
First Line : 309 LYNNHAVEN PKWY STE 100
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-7411
Country : US
Telephone Number : 757-385-2132
Fax Number : 757-427-2480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 02/09/2024

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Directions to “ SANDRA S QUARLES LCSW” Practice Location

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