Provider Demographics
NPI:1487198156
Name:SACHS, ROSE LESLIE (LCSW(VA) LCSW-C(MD))
Entity Type:Individual
Prefix:MS
First Name:ROSE
Middle Name:LESLIE
Last Name:SACHS
Suffix:
Gender:F
Credentials:LCSW(VA) LCSW-C(MD)
Other - Prefix:MRS
Other - First Name:ROSE
Other - Middle Name:SACHS
Other - Last Name:BERNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 PENICK PLACE
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:VA
Mailing Address - Zip Code:24101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 PENICK PLACE
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:VA
Practice Address - Zip Code:24101
Practice Address - Country:US
Practice Address - Phone:301-529-3294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VALCSW09040086141041C0700X
MDLCSW-C107121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical