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Sandra O Bryant

Counselor

Behavioral Health & Social Service Providers

2215 Langhorne Rd, Suite 104, Lynchburg, VA 24501-1121

PECOS Enrollment

Based on the most recent information from CMS, provider Sandra O Bryant does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1578664090
Provider Type
Individual
Full Name
Bryant, Sandra O
Credential
LPC,RN

Gender
Female
Sole Proprietor
No
Enumeration Date
9/26/2006
Last Updated
9/12/2012

Contact Information

Practice Location

2215 Langhorne Rd, Suite 104, Lynchburg, VA 24501-1121

(434) 455-3047

(434) 948-4918

Mailing Location

2215 Langhorne Rd, Suite 104, Lynchburg, VA 24501-1121

(434) 455-3047

(434) 948-4918

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 0701002573 Virginia
Code 106H00000X	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 0717000669 Virginia

Provider Identifiers

ID	Description	Issuer
ID 243077	Description Other	Issuer ANTHEM Virginia
ID 004945441	Description Medicaid	Issuer Unlisted Virginia

Sandra O Bryant

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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