Provider Demographics
NPI:1639969975
Name:EMBRY, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:EMBRY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 RAMSGATE LN APT A
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-5314
Mailing Address - Country:US
Mailing Address - Phone:502-424-4173
Mailing Address - Fax:
Practice Address - Street 1:1412 RAMSGATE LN APT A
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-5314
Practice Address - Country:US
Practice Address - Phone:502-424-4173
Practice Address - Fax:502-424-4173
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704016561101Y00000X
VA0730000714106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor