Provider Demographics
NPI:1992824114
Name:RUSS, SARAH J (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:J
Last Name:RUSS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1296 CRONSON BLVD UNIT 3832
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-7526
Mailing Address - Country:US
Mailing Address - Phone:347-389-4043
Mailing Address - Fax:
Practice Address - Street 1:2330 TURNBRIDGE CT
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-3270
Practice Address - Country:US
Practice Address - Phone:347-389-4043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD229421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical