Provider Demographics
NPI:1679852347
Name:ELLIOTT, SARAH M (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 COURT ST
Mailing Address - Street 2:5TH FL
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24504-1312
Mailing Address - Country:US
Mailing Address - Phone:434-485-8861
Mailing Address - Fax:434-485-8877
Practice Address - Street 1:620 COURT ST
Practice Address - Street 2:5TH FL
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-1312
Practice Address - Country:US
Practice Address - Phone:434-485-8861
Practice Address - Fax:434-485-8877
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0701004668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1871542340Medicaid