Provider Demographics
NPI:1053813816
Name:SHAKER, SARAH C (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:C
Last Name:SHAKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 TRILBY CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-2237
Mailing Address - Country:US
Mailing Address - Phone:757-785-5682
Mailing Address - Fax:
Practice Address - Street 1:464 INVESTORS PL STE 204I
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1167
Practice Address - Country:US
Practice Address - Phone:757-785-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-07
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional