Provider Demographics
NPI:1487004719
Name:MCCLAIN, SARA (ACCREDITED)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:ACCREDITED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4869 CLOPTON DR
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-2514
Mailing Address - Country:US
Mailing Address - Phone:757-775-2160
Mailing Address - Fax:
Practice Address - Street 1:4869 CLOPTON DR
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-2514
Practice Address - Country:US
Practice Address - Phone:757-775-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA46900101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor