Provider Demographics
NPI:1295196376
Name:MCCAULEY, SARA GREENE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:GREENE
Last Name:MCCAULEY
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 1:904 ROLFE PL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1384
Mailing Address - Country:US
Mailing Address - Phone:520-780-9901
Mailing Address - Fax:
Practice Address - Street 1:102 CUSTER RD
Practice Address - Street 2:BUILDING 203
Practice Address - City:FORT MYER
Practice Address - State:VA
Practice Address - Zip Code:22211-1228
Practice Address - Country:US
Practice Address - Phone:703-696-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-136531041C0700X
DCLC500804571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical