Provider Demographics
NPI:1780379263
Name:PIRMOHAMED, SARA (LCPC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:PIRMOHAMED
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 EAGLE PASSAGES CT
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-1239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 OLD SOLOMONS ISLAND RD STE A
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-0920
Practice Address - Country:US
Practice Address - Phone:443-214-5097
Practice Address - Fax:443-440-5782
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP8631101YP2500X
MDLC15237101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional