Provider Demographics
NPI:1285061739
Name:DUCKERY, SARA CHRISTINE (LICSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:CHRISTINE
Last Name:DUCKERY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 49TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-4706
Mailing Address - Country:US
Mailing Address - Phone:202-388-6870
Mailing Address - Fax:202-727-8330
Practice Address - Street 1:301 49TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-4706
Practice Address - Country:US
Practice Address - Phone:202-388-6870
Practice Address - Fax:202-727-8330
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500791291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical