Provider Demographics
NPI:1861870388
Name:MENDELSON, SARA N (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:N
Last Name:MENDELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 WESTERN BRANCH BLVD
Mailing Address - Street 2:#F
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5138
Mailing Address - Country:US
Mailing Address - Phone:757-673-3644
Mailing Address - Fax:757-337-0165
Practice Address - Street 1:3356 WESTERN BRANCH BLVD
Practice Address - Street 2:#F
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5138
Practice Address - Country:US
Practice Address - Phone:757-673-3644
Practice Address - Fax:757-337-0165
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-16
Last Update Date:2015-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040031751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical