Provider Demographics
NPI:1063458891
Name:ALBRIGHT, SANDRA G (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:G
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 WOODLAWN AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-4224
Mailing Address - Country:US
Mailing Address - Phone:540-904-2404
Mailing Address - Fax:
Practice Address - Street 1:FAMILY SERVICE OF ROANOKE VALLEY
Practice Address - Street 2:360 CAMPBELL AVE., S.W.
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016
Practice Address - Country:US
Practice Address - Phone:540-563-5316
Practice Address - Fax:540-563-5254
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040014301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904001430OtherL.C.S.W.