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NPI Code Detail

MEDICARE: MS. SARAH ANITA WATTENBERG LCSW-C

MEDICARE: MS. SARAH ANITA WATTENBERG LCSW-C
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
11041C0700XClinical Social Worker07101MD

General Provider Information

NPI Number : 1982342218
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARAH ANITA WATTENBERG LCSW-C
Provider Business Mailing Address
First Line : 4104 MITSCHER CT
Second Line :
City : KENSINGTON
State : MD
Zip : 20895-1307
Country : US
Telephone Number : 240-460-7604
Fax Number :
Provider Business Practice Location Address
First Line : 4104 MITSCHER CT
Second Line :
City : KENSINGTON
State : MD
Zip : 20895-1307
Country : US
Telephone Number : 240-460-7604
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2022
Last Update Date : 05/25/2022

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Directions to “ MS. SARAH ANITA WATTENBERG LCSW-C” Practice Location

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