Provider Demographics
NPI:1194146092
Name:DUFOUR, SARAH (MSW, LMSW)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:DUFOUR
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 BESTOR DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2100
Mailing Address - Country:US
Mailing Address - Phone:240-740-2150
Mailing Address - Fax:
Practice Address - Street 1:4511 BESTOR DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-2100
Practice Address - Country:US
Practice Address - Phone:240-740-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD239871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1194146092Medicaid