Provider Demographics
NPI:1598762569
Name:SAYRE, STEVEN EARLE (LCSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:EARLE
Last Name:SAYRE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E SOUTH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5217
Mailing Address - Country:US
Mailing Address - Phone:434-971-4747
Mailing Address - Fax:434-293-4690
Practice Address - Street 1:100 E SOUTH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5217
Practice Address - Country:US
Practice Address - Phone:434-971-4747
Practice Address - Fax:434-293-4690
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040008511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
800000066Medicare ID - Type Unspecified