Provider Demographics
NPI:1114038601
Name:SADLER, REBECCA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SADLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:EBELING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4351 HACKNEY COACH LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7953
Mailing Address - Country:US
Mailing Address - Phone:703-798-9136
Mailing Address - Fax:
Practice Address - Street 1:1850 CAMERON GLEN DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3363
Practice Address - Country:US
Practice Address - Phone:703-481-4163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health