1487198156 NPI number — MS. ROSE LESLIE SACHS LCSW(VA) LCSW-C(MD)

Table of content: MS. ROSE LESLIE SACHS LCSW(VA) LCSW-C(MD) (NPI 1487198156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487198156 NPI number — MS. ROSE LESLIE SACHS LCSW(VA) LCSW-C(MD)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SACHS
Provider First Name:
ROSE
Provider Middle Name:
LESLIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW(VA) LCSW-C(MD)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BERNSTEIN
Provider Other First Name:
ROSE
Provider Other Middle Name:
SACHS
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487198156
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
99 PENICK PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARDY
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
99 PENICK PLACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARDY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-529-3294
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/14/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCSW0904008614 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: LCSW-C10712 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)