Provider Demographics
NPI:1649774456
Name:BARGA, MICHAEL JOSEPH SACO
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH SACO
Last Name:BARGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1118
Mailing Address - Country:US
Mailing Address - Phone:240-478-0930
Mailing Address - Fax:
Practice Address - Street 1:18715 N FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3121
Practice Address - Country:US
Practice Address - Phone:240-364-8453
Practice Address - Fax:301-519-2533
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical