Provider Demographics
NPI:1770037012
Name:MURRY, SARA DIANE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:DIANE
Last Name:MURRY
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 1:3008 ALABAMA AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2208
Mailing Address - Country:US
Mailing Address - Phone:443-330-7734
Mailing Address - Fax:
Practice Address - Street 1:5840 BANNEKER RD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3156
Practice Address - Country:US
Practice Address - Phone:443-330-7734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20294104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker