Provider Demographics
NPI:1962741017
Name:BARCA, SALLY ELIZABETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:ELIZABETH
Last Name:BARCA
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 1:1703 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4733
Mailing Address - Country:US
Mailing Address - Phone:434-209-0369
Mailing Address - Fax:
Practice Address - Street 1:1703 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4733
Practice Address - Country:US
Practice Address - Phone:434-209-0369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-10
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904007825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health