MEDICARE: SARA NOVAK LCSW-C, MAC

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	171100000X	Acupuncturist	U02887	MD

General Provider Information

NPI Number	:	1730371139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA NOVAK LCSW-C, MAC

Provider Business Mailing Address
First Line	:	3172 SAINT JOHNS LN
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2602
Country	:	US
Telephone Number	:	443-900-3177
Fax Number	:

Provider Business Practice Location Address
First Line	:	7300 GRACE DR STE A
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2473
Country	:	US
Telephone Number	:	443-312-9560
Fax Number	:

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

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	03/10/2023

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