Provider Demographics
NPI:1447356407
Name:INCE, SARAH DOROTHY (LCSW)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:DOROTHY
Last Name:INCE
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 1:3018 JAVIER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4609
Mailing Address - Country:US
Mailing Address - Phone:703-204-9100
Mailing Address - Fax:703-204-9590
Practice Address - Street 1:3018 JAVIER RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4609
Practice Address - Country:US
Practice Address - Phone:703-204-9100
Practice Address - Fax:703-204-9590
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904004483104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker