Provider Demographics
NPI:1770037012
Name:MURRY, SARA DIANE (LCSW-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:DIANE
Last Name:MURRY
Suffix:
Gender:X
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-2632
Mailing Address - Country:US
Mailing Address - Phone:410-491-4333
Mailing Address - Fax:
Practice Address - Street 1:4901 HARFORD RD UNIT 3623
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-7509
Practice Address - Country:US
Practice Address - Phone:410-343-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20294104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker