Provider Demographics
NPI:1255302147
Name:WALKER, SARA J (LSCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:WALKER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17028 FLATWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2538
Mailing Address - Country:US
Mailing Address - Phone:240-751-3725
Mailing Address - Fax:
Practice Address - Street 1:17028 FLATWOOD DR
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-2538
Practice Address - Country:US
Practice Address - Phone:240-751-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158191041C0700X
DCLC500788661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD100097940AMedicaid
DC100097940AMedicaid
DC100097940AMedicaid
MD100097940AMedicaid