Healthcare Provider Details

I. General information

NPI: 1114212420
Provider Name (Legal Business Name): SARAH FAITH EVANS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 W PADONIA RD SUITE C-252
LUTHERVILLE MD
21093-2226
US

IV. Provider business mailing address

9014 ROCK LEDGE CT #302
OWINGS MILLS MD
21117-7039
US

V. Phone/Fax

Practice location:
  • Phone: 410-561-1114
  • Fax:
Mailing address:
  • Phone: 443-797-4307
  • Fax: 443-352-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: