Provider Demographics
NPI:1215351408
Name:LEVEN, SARA JUDITH (LCPC)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:JUDITH
Last Name:LEVEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MILFORD MILL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5902
Mailing Address - Country:US
Mailing Address - Phone:410-241-5975
Mailing Address - Fax:
Practice Address - Street 1:201 MILFORD MILL RD STE 105
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5902
Practice Address - Country:US
Practice Address - Phone:410-241-5975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC4485101Y00000X
MDLC485101YM0800X
MDLC4485101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional