Provider Demographics
NPI:1366193427
Name:JOHNSON, SARIT (LCSW)
Entity type:Individual
Prefix:
First Name:SARIT
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARIT
Other - Middle Name:
Other - Last Name:WING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:808 WIGGINGTON RD
Mailing Address - Street 2:STE D
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5155
Mailing Address - Country:US
Mailing Address - Phone:434-616-4980
Mailing Address - Fax:540-765-3369
Practice Address - Street 1:808 WIGGINGTON RD
Practice Address - Street 2:STE D
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5155
Practice Address - Country:US
Practice Address - Phone:434-616-4980
Practice Address - Fax:540-765-3369
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040135681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical