Provider Demographics
NPI:1538719612
Name:COXON, SARA EVALYN
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:EVALYN
Last Name:COXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 LIBBIE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-2364
Mailing Address - Country:US
Mailing Address - Phone:804-303-9622
Mailing Address - Fax:804-716-4318
Practice Address - Street 1:5706 GROVE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2343
Practice Address - Country:US
Practice Address - Phone:804-363-0300
Practice Address - Fax:804-636-0300
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040029441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical