Provider Demographics
NPI:1386016277
Name:GHOLSON, SARAH S (M DIV, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:S
Last Name:GHOLSON
Suffix:
Gender:F
Credentials:M DIV, LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SELLERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M DIV, LPC
Mailing Address - Street 1:5912 HARBOUR PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2135
Mailing Address - Country:US
Mailing Address - Phone:804-464-1928
Mailing Address - Fax:804-893-3046
Practice Address - Street 1:5912 HARBOUR PARK DR STE B
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2135
Practice Address - Country:US
Practice Address - Phone:804-464-1928
Practice Address - Fax:804-893-3046
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001878101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional