Provider Demographics
NPI:1053046136
Name:SARAH J MCBRIDE LLC
Entity Type:Organization
Organization Name:SARAH J MCBRIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-779-6202
Mailing Address - Street 1:4509 WHITECHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6447
Mailing Address - Country:US
Mailing Address - Phone:757-460-4655
Mailing Address - Fax:
Practice Address - Street 1:4509 WHITECHAPEL DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6447
Practice Address - Country:US
Practice Address - Phone:757-460-4655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health