Provider Demographics
NPI:1730312117
Name:CONRAD, SARAH (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:CONRAD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3932 SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-4119
Mailing Address - Country:US
Mailing Address - Phone:804-269-1217
Mailing Address - Fax:
Practice Address - Street 1:3932 SPRINGFIELD RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-4119
Practice Address - Country:US
Practice Address - Phone:804-269-1217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001187106H00000X
CA41961106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist