Provider Demographics
NPI:1609215144
Name:GILDEN, SARAH R (MS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:GILDEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14800 PHYSICIANS LN
Mailing Address - Street 2:SUITE 231
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3940
Mailing Address - Country:US
Mailing Address - Phone:240-670-6822
Mailing Address - Fax:301-762-6646
Practice Address - Street 1:14800 PHYSICIANS LN
Practice Address - Street 2:SUITE 231
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3940
Practice Address - Country:US
Practice Address - Phone:240-670-6822
Practice Address - Fax:301-762-6646
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD755875Medicaid