Provider Demographics
NPI:1164579306
Name:HAMMACK, SARAH NELSON (LCSW-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:NELSON
Last Name:HAMMACK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1614
Mailing Address - Country:US
Mailing Address - Phone:301-503-8676
Mailing Address - Fax:301-530-9219
Practice Address - Street 1:8818 GEORGIA AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2713
Practice Address - Country:US
Practice Address - Phone:301-563-7007
Practice Address - Fax:301-563-7009
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD003427400Medicaid