Healthcare Provider Details

I. General information

NPI: 1679200018
Provider Name (Legal Business Name): SARAH TOMPKINS RATHBUN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/05/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W PRATT ST
BALTIMORE MD
21201-1023
US

IV. Provider business mailing address

109 N ELLWOOD AVE
BALTIMORE MD
21224-1308
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-3522
  • Fax:
Mailing address:
  • Phone: 717-215-9922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number28915
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: