Provider Demographics
NPI:1952847915
Name:DIEHL, SARAH (MDIV, MS, LCPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DIEHL
Suffix:
Gender:F
Credentials:MDIV, MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4504
Mailing Address - Country:US
Mailing Address - Phone:410-382-9800
Mailing Address - Fax:
Practice Address - Street 1:1702 SOUTH RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4504
Practice Address - Country:US
Practice Address - Phone:410-382-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7610101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional