| Sarah Hickey, | |
|
102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 | |
| (703) 771-5100 | |
| (703) 777-0170 |
| Full Name | Sarah Hickey |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 102 Heritage Way Ne Ste 302, Leesburg, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326587809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (NU) | Primary |
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 1041C0700X | Social Worker - Clinical | (NU) | Secondary |
| Entity Name | Prince William County Community Services Board |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053402800 PECOS PAC ID: 7113912973 Enrollment ID: O20040420000249 |
| Entity Name | Youth for Tomorrow New Life Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316118292 PECOS PAC ID: 1951673227 Enrollment ID: O20170822000018 |
| Mailing Address | Practice Location Address |
|---|---|
| Sarah Hickey, 102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 Ph: (703) 771-5100 | Sarah Hickey, 102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 Ph: (703) 771-5100 |
Erka Mucaj, LPC Counselor Medicare: Medicare Enrolled Practice Location: 102 Heritage Way Ne Ste 302, Leesburg, VA 20176 Phone: 703-771-5100 Fax: 703-777-0170 |
Hannah Purvis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 26 N King St, Leesburg, VA 20176 Phone: 571-554-6366 |
Ms. Carrie Annette Cecca, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Heritage Way Ne, Suite 302, Leesburg, VA 20176 Phone: 703-771-5100 Fax: 703-777-0170 |
Mrs. Sonal Aneil Butani, Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Heritage Way Ne Ste 302, Leesburg, VA 20176 Phone: 703-771-5100 Fax: 703-777-0170 |
Monica Andrea Taylor, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 19 Fort Evans Rd Ne Ste C, Leesburg, VA 20176 Phone: 571-472-2500 |
Carlton Mack, Counselor Medicare: Not Enrolled in Medicare Practice Location: 222 Catoctin Cir Se Fl 2, Leesburg, VA 20175 Phone: 571-609-5351 |
Joni Elizabeth Rodriguez, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Heritage Way Ne Ste 302, Leesburg, VA 20176 Phone: 703-771-5100 Fax: 703-777-0170 |