Provider Demographics
NPI:1588837009
Name:SMOLEY, SARA K (LCSW-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:K
Last Name:SMOLEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:K
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8615 RIDGELYS CHOICE DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8615 RIDGELYS CHOICE DR
Practice Address - Street 2:SUITE 212
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-3026
Practice Address - Country:US
Practice Address - Phone:410-529-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD139091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical