Healthcare Provider Details

I. General information

NPI: 1497163976
Provider Name (Legal Business Name): SARAH ROGERSON POGUE LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 1ST ST NE 9TH FLOOR
WASHINGTON DC
20002-3361
US

IV. Provider business mailing address

1200 1ST ST NE 9TH FLOOR
WASHINGTON DC
20002-3361
US

V. Phone/Fax

Practice location:
  • Phone: 202-442-4800
  • Fax:
Mailing address:
  • Phone: 202-442-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50079567
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: