Provider Demographics
NPI:1285727867
Name:MERCHANT, SARA C (LCSW C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:C
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:LCSW C
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:C
Other - Last Name:MERCHANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW C
Mailing Address - Street 1:10400 RIDGELAND ROAD STE 1
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030
Mailing Address - Country:US
Mailing Address - Phone:410-628-6120
Mailing Address - Fax:410-628-9825
Practice Address - Street 1:3525 RESOURCE DRIVE ROOM C47
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133
Practice Address - Country:US
Practice Address - Phone:410-655-7655
Practice Address - Fax:410-655-3941
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD008311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
41792401OtherCAREFIRST MD
R5830040OtherCAREFIRST GHMSI
234417OtherCOMPSYCH
41792401OtherCAREFIRST MD