Healthcare Provider Details

I. General information

NPI: 1003230442
Provider Name (Legal Business Name): SARA A HAINA LCSW-C, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 CRAIN HWY
WHITE PLAINS MD
20695-3045
US

IV. Provider business mailing address

4545 CRAIN HWY
WHITE PLAINS MD
20695-3045
US

V. Phone/Fax

Practice location:
  • Phone: 301-609-6616
  • Fax: 301-934-1234
Mailing address:
  • Phone: 301-609-6616
  • Fax: 301-934-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCA304
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number07359
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: