Provider Demographics
NPI:1942708292
Name:PASSARO, SARA RUTH (LICSW, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:RUTH
Last Name:PASSARO
Suffix:
Gender:F
Credentials:LICSW, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7507 HOGARTH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2916
Mailing Address - Country:US
Mailing Address - Phone:609-549-1013
Mailing Address - Fax:
Practice Address - Street 1:7507 HOGARTH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2916
Practice Address - Country:US
Practice Address - Phone:609-549-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-41342103K00000X
FLRBT-18-48009106S00000X
DCLC2000040031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician