Healthcare Provider Details

I. General information

NPI: 1841396041
Provider Name (Legal Business Name): SARAH M HOFSOMMER LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH M MOELLER LGSW, LCSW-C

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N GREENE ST
BALTIMORE MD
21201-1524
US

IV. Provider business mailing address

6600 YORK RD STE 202A
BALTIMORE MD
21212-2024
US

V. Phone/Fax

Practice location:
  • Phone: 410-637-1226
  • Fax: 410-637-1439
Mailing address:
  • Phone: 443-384-7366
  • Fax: 410-637-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberG11725
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14361
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: