Provider Demographics
NPI:1184959421
Name:BISHOP, SARAH BLAIR (LPC, CSAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BLAIR
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3517 BRANDON AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-1523
Mailing Address - Country:US
Mailing Address - Phone:540-981-1102
Mailing Address - Fax:540-344-4169
Practice Address - Street 1:3517 BRANDON AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1523
Practice Address - Country:US
Practice Address - Phone:540-981-1102
Practice Address - Fax:540-344-4169
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004634101YP2500X
VA0710102994101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)