Provider Demographics
NPI:1538213319
Name:SAYRE, MICHELLE WALKER (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:WALKER
Last Name:SAYRE
Suffix:
Gender:F
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 1:3330 COOL BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028-1108
Mailing Address - Country:US
Mailing Address - Phone:410-734-7380
Mailing Address - Fax:
Practice Address - Street 1:39 KENSINGTON PKWY
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1851
Practice Address - Country:US
Practice Address - Phone:410-459-3844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical