Individual ProviderSandra O BryantCounselorBehavioral Health & Social Service ProvidersPractice Address2215 Langhorne Rd, Suite 104, Lynchburg, VA 24501-1121(434) 455-3047PECOS EnrollmentBased on the most recent information from CMS, provider Sandra O Bryant does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1578664090Provider TypeIndividualFull NameBryant, Sandra OCredentialLPC,RNGenderFemaleSole ProprietorNoEnumeration Date9/26/2006Last Updated9/12/2012Contact InformationPractice LocationPractice Address2215 Langhorne Rd, Suite 104, Lynchburg, VA 24501-1121Phone(434) 455-3047Fax(434) 948-4918Mailing LocationMailing Address2215 Langhorne Rd, Suite 104, Lynchburg, VA 24501-1121Phone(434) 455-3047Fax(434) 948-4918Provider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense0701002573VirginiaCode106H00000XDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense0717000669VirginiaProvider IdentifiersIDDescriptionIssuerID243077DescriptionOtherIssuerANTHEMVirginiaID004945441DescriptionMedicaidIssuerUnlistedVirginia