Provider Demographics
NPI:1841920691
Name:ELKALBAN, SARAH GRACE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:ELKALBAN
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 1:41917 BERYL TER
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-2906
Mailing Address - Country:US
Mailing Address - Phone:703-732-5222
Mailing Address - Fax:
Practice Address - Street 1:44135 WOODRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8282
Practice Address - Country:US
Practice Address - Phone:571-528-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health