Provider Demographics
NPI:1649301490
Name:MINDEL, SARA (LICSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MINDEL
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 1:1407 S ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3819
Mailing Address - Country:US
Mailing Address - Phone:202-939-7668
Mailing Address - Fax:202-939-7655
Practice Address - Street 1:1701 R ST. NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009
Practice Address - Country:US
Practice Address - Phone:202-939-7668
Practice Address - Fax:202-939-7655
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500781641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical