Provider Demographics
NPI:1659464535
Name:MCMANUS, SARA JANE (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JANE
Last Name:MCMANUS
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 1:1317 BAYSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-3607
Mailing Address - Country:US
Mailing Address - Phone:703-810-1002
Mailing Address - Fax:
Practice Address - Street 1:1317 BAYSHIRE LN
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3607
Practice Address - Country:US
Practice Address - Phone:703-810-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040062961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical