Provider Demographics
NPI:1427746064
Name:PENA, SARAH (LMSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PENA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7725 HORNBEAM DR UNIT 240
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-7966
Mailing Address - Country:US
Mailing Address - Phone:702-234-9401
Mailing Address - Fax:
Practice Address - Street 1:1363 BECKNEL AVE
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1501
Practice Address - Country:US
Practice Address - Phone:410-760-9079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29106104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker