Provider Demographics
NPI:1336461359
Name:TUKE, SARA L (MA, LPC, LCPC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:TUKE
Suffix:
Gender:F
Credentials:MA, LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4677 34TH ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1701
Mailing Address - Country:US
Mailing Address - Phone:240-997-2442
Mailing Address - Fax:
Practice Address - Street 1:1495 CHAIN BRIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5727
Practice Address - Country:US
Practice Address - Phone:703-745-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004741101YM0800X
MDLC3318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health