Provider Demographics
NPI:1689905051
Name:TYLER, SARAH TAYLOR (LCSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:TAYLOR
Last Name:TYLER
Suffix:
Gender:F
Credentials:LCSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 CAPITOL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-2618
Mailing Address - Country:US
Mailing Address - Phone:703-856-3154
Mailing Address - Fax:
Practice Address - Street 1:1487 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5723
Practice Address - Country:US
Practice Address - Phone:703-856-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040045521041C0700X
MD103441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical