Provider Demographics
NPI:1780219303
Name:STUART, SARA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:STUART
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4400 SMOKEY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4736
Mailing Address - Country:US
Mailing Address - Phone:757-470-1689
Mailing Address - Fax:757-961-4180
Practice Address - Street 1:258 N WITCHDUCK RD STE 2A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6556
Practice Address - Country:US
Practice Address - Phone:757-642-5158
Practice Address - Fax:757-961-4180
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008883101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional