Provider Demographics
NPI:1376351734
Name:JESUP, SARAH (MA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:JESUP
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 U ST NW APT 717
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3531
Mailing Address - Country:US
Mailing Address - Phone:703-899-2908
Mailing Address - Fax:
Practice Address - Street 1:1100 H ST NW STE 220
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-5489
Practice Address - Country:US
Practice Address - Phone:301-922-5759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health