MEDICARE: SARAH MALDONADO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	80791	TX
3	101YP2500X	Professional Counselor	80791	TX

General Provider Information

NPI Number	:	1689328114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MALDONADO LPC

Provider Business Mailing Address
First Line	:	2505 BIRD ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-1313
Country	:	US
Telephone Number	:	512-967-3592
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 N RIVERSIDE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-2732
Country	:	US
Telephone Number	:	512-967-3592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2022
Last Update Date	:	06/26/2025

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Directions to “ SARAH MALDONADO LPC” Practice Location

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