Provider Demographics
NPI:1063245991
Name:THORPE, SIERRA ASHLEY
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:ASHLEY
Last Name:THORPE
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 1:1028 S WALTER REED DR APT 705
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-0826
Mailing Address - Country:US
Mailing Address - Phone:703-677-2683
Mailing Address - Fax:
Practice Address - Street 1:6400 GROVEDALE DR STE 200
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2504
Practice Address - Country:US
Practice Address - Phone:571-414-9645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013907101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional