Healthcare Provider Details

I. General information

NPI: 1053815373
Provider Name (Legal Business Name): SARAH CARSTENS NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23160 MOAKLEY ST
LEONARDTOWN MD
20650-2922
US

IV. Provider business mailing address

23160 MOAKLEY ST
LEONARDTOWN MD
20650-2922
US

V. Phone/Fax

Practice location:
  • Phone: 301-475-5511
  • Fax:
Mailing address:
  • Phone: 301-475-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number38882
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPPS-0605926
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: