Provider Demographics
NPI:1093180119
Name:NOWACZYK, SARAH FISCHER (PH D)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:FISCHER
Last Name:NOWACZYK
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PH D
Mailing Address - Street 1:2636 BOWLING GREEN DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-7030
Mailing Address - Country:US
Mailing Address - Phone:706-296-0233
Mailing Address - Fax:
Practice Address - Street 1:2001 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 211
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3603
Practice Address - Country:US
Practice Address - Phone:571-257-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004695103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical