Provider Demographics
NPI:1265909097
Name:LIM, SARAH JUNGSOO (LPC)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:JUNGSOO
Last Name:LIM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JUNG SOO
Other - Middle Name:
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:11204 WAPLES MILL RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:703-218-8500
Mailing Address - Fax:703-359-0463
Practice Address - Street 1:11204 WAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:703-218-8500
Practice Address - Fax:703-359-0463
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YP2500X
VA0701008155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional