Provider Demographics
NPI:1154568541
Name:JOHNSON, SARAH ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 DULANEY VALLEY RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5132
Mailing Address - Country:US
Mailing Address - Phone:443-310-5746
Mailing Address - Fax:888-425-7224
Practice Address - Street 1:744 DULANEY VALLEY RD
Practice Address - Street 2:SUITE 14
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-5132
Practice Address - Country:US
Practice Address - Phone:443-310-5746
Practice Address - Fax:888-425-7224
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04824103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical