Provider Demographics
NPI:1184245508
Name:VANLANDINGHAM, SARAH
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:VANLANDINGHAM
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 1:552 FORT EVANS RD STE 206
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3378
Mailing Address - Country:US
Mailing Address - Phone:703-777-7755
Mailing Address - Fax:
Practice Address - Street 1:552 FORT EVANS RD STE 206
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3378
Practice Address - Country:US
Practice Address - Phone:703-777-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006373103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical