MEDICARE: SARAH T DU LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW022971	PA
2	104100000X	Social Worker	SW136939	PA
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	12554	PA
4	101Y00000X	Counselor

General Provider Information

NPI Number	:	1174088868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH T DU LCSW

Provider Business Mailing Address
First Line	:	701 E CATHEDRAL RD STE 45
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-2128
Country	:	US
Telephone Number	:	609-400-2317
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 E CATHEDRAL RD STE 45
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-2128
Country	:	US
Telephone Number	:	609-400-2317
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2019
Last Update Date	:	01/08/2026

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