Provider Demographics
NPI:1346134822
Name:SACKIE, AROSTY
Entity type:Individual
Prefix:
First Name:AROSTY
Middle Name:
Last Name:SACKIE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:AROSTY
Other - Middle Name:
Other - Last Name:SAKIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RUBY
Mailing Address - Street 1:15101 CEDAR TREE DR
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1152
Mailing Address - Country:US
Mailing Address - Phone:240-390-5877
Mailing Address - Fax:
Practice Address - Street 1:15101 CEDAR TREE DR
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1152
Practice Address - Country:US
Practice Address - Phone:240-390-5877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4GK1172106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician